术后呼叫医生进行髋关节骨折修复:一项多中心回顾性研究。
Hip Fracture Repair by the Post-Call Surgeon: A Multicenter Retrospective Review.
机构信息
From the Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA (Dr. Anderson, Dr. Sing, and Dr. Tornetta); the Department of Orthopaedic Surgery, University of Texas Health Sciences Center, Houston, TX (Dr. Pechero, Dr. Gary); the Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA (Dr. Hagar, Dr. Ryan); the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Dvozhinskiy and Dr. Ricci); the Department of Orthopaedic Surgery, MetroHealth, Cleveland, OH (Ms. Fraifogl and Dr. Vallier); the Department of Orthopaedic Surgery, Indiana University Health, Indianapolis, IN (Dr. Fischer, Dr. Mullis); the Department of Orthopaedic Surgery, QEII Health Sciences Centre, Halifax Infirmary, Halifax, NS (Dr. Alqudhaya and Dr. Leighton); the Department of Orthopaedic Surgery, Geisinger Health, Pennsylvania, PA (Dr. Baig and Dr. Horwitz); and the Department of Orthopaedic Surgery, Beth Israel Lahey Health, Burlington, MA (Ms. Bramlett, Dr. Marcantonio).
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 16;8(2). doi: 10.5435/JAAOSGlobal-D-24-00016. eCollection 2024 Feb 1.
INTRODUCTION
The purpose of this study was to evaluate surgeons' ability to perform or supervise a standard operation with agreed-upon radiologic parameters after being on call.
METHODS
We reviewed a consecutive series of patients with intertrochanteric hip fractures treated with a fixed angle device at 9 centers and compared corrected tip-apex distance and reduction quality for post-call surgeons versus those who were not. Subgroup analyses included surgeons who operated the night before versus not and attending-only versus resident involved cases. Secondary outcomes included union and perioperative complications.
RESULTS
One thousand seven hundred fourteen patients were of average age 77 years. Post-call surgeons treated 823 patients and control surgeons treated 891. Surgical corrected tip-apex distance did not differ between groups: on-call 18 mm versus control 18 mm (P = 0.59). The Garden indices were 160° on the AP and 179° on the lateral in both groups. In 66 cases performed by surgeons who operated the night before, the TAD was 17 mm. No difference was noted in corrected tip-apex distance with and without resident involvement (P = 0.101). No difference was observed in pooled fracture-related complications (P = 0.23).
CONCLUSION
Post-call surgeons demonstrated no difference in quality and no increase in complications when performing hip fracture repair the next day compared with surgeons who were not on call.
简介
本研究的目的是评估外科医生在值班后是否能够按照既定的放射学参数进行或监督标准手术。
方法
我们回顾了 9 个中心连续系列的采用固定角度装置治疗的转子间髋部骨折患者,并比较了值班后外科医生与未值班的外科医生的校正尖端距(TAD)和复位质量。亚组分析包括前一天手术的外科医生与未手术的外科医生,以及仅主治医生参与的病例与主治医生和住院医师共同参与的病例。次要结局包括愈合和围手术期并发症。
结果
1714 例患者的平均年龄为 77 岁。值班后外科医生治疗了 823 例患者,对照组外科医生治疗了 891 例患者。两组之间的手术校正 TAD 没有差异:值班组 18mm 与对照组 18mm(P=0.59)。前后位的 Garden 指数为 160°,侧位为 179°。在前一天手术的 66 例患者中,TAD 为 17mm。有和没有住院医师参与时,校正 TAD 没有差异(P=0.101)。在骨折相关并发症方面,两组之间没有差异(P=0.23)。
结论
与未值班的外科医生相比,值班后的外科医生在第二天进行髋部骨折修复时,在手术质量方面没有差异,并发症也没有增加。
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