Cost benefit with early operative fixation of unstable ankle fractures.
Ann R Coll Surg Engl
; 88(4): 405-7, 2006 Jul.
Article
em En
| MEDLINE
| ID: mdl-16834865
ABSTRACT
INTRODUCTION:
Ankle fractures are common and many require surgical intervention. It has been well documented that a delay in fracture fixation results in increased length of hospital stay and increased complication rate. Initial delay can also allow swelling or blistering to develop which may necessitate a further delay in operative fixation for up to 1 week. The aim of the current study was to review the length of hospital in-patient stay for operative ankle fractures over the previous 12-month period at our hospital and compare this to the length of hospital stay following the introduction of a fast-track system for the fixation of these fractures (all fractures fixed within 48 h). PATIENTS ANDMETHODS:
A retrospective review of all ankle fractures managed by open reduction and internal fixation over a 12-month period was undertaken. A protocol was then agreed to openly reduce and fix these fractures at the earliest possible opportunity over the next 6-month period. We then collected the data on all ankle fractures that needed open reduction and internal fixation over this 6-month period. The pre-protocol and post-protocol groups were then compared for total hospital length of stay and complication rate.RESULTS:
In the 12-month retrospective review, there were 83 ankle fractures that required surgical intervention. Sixty-two of these had surgery within 48 h (mean length of stay, 5.4 days), and 21 had surgery after 48 h (mean length of stay, 9.5 days). There were 39 ankle fractures in the post-protocol group who all had surgery within 48 h (mean length of stay, 5 days). There was no increase in complication rate after implementation of the fast-track system.CONCLUSIONS:
This study shows that early operative intervention for ankle fractures reduces the length of hospital stay. Intensive physiotherapy and co-ordinated discharge planning are also essential ingredients for early discharge. Early operative fixation for unstable ankle fractures has substantial cost-saving implications with no increase in complication rate.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos do Tornozelo
/
Fraturas Ósseas
/
Fixação de Fratura
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Ann R Coll Surg Engl
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Reino Unido