Complication rates after proximal femoral nailing: does level of training matter?
Abstract Background Surgical treatment of pertrochanteric fractures is one of the most performed surgeries in orthogeriatrics. Proximal femoral nailing, the most performed procedure, is often used as a training surgery for young residents. The objective of this study was to evaluate the relevance of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-11-01
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| Series: | Journal of Orthopaedics and Traumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s10195-023-00737-z |
| _version_ | 1797636776672624640 |
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| author | D. J. Haslhofer J. M. Stiftinger N. Kraml F. Dannbauer C. Schmolmüller T. Gotterbarm O. Kwasny A. Klasan |
| author_facet | D. J. Haslhofer J. M. Stiftinger N. Kraml F. Dannbauer C. Schmolmüller T. Gotterbarm O. Kwasny A. Klasan |
| author_sort | D. J. Haslhofer |
| collection | DOAJ |
| description | Abstract Background Surgical treatment of pertrochanteric fractures is one of the most performed surgeries in orthogeriatrics. Proximal femoral nailing, the most performed procedure, is often used as a training surgery for young residents. The objective of this study was to evaluate the relevance of the resident’s training level to complication rates. Material and methods This study was a retrospective cohort study. Surgeons were divided into four groups according to their training level. Complications included infection, cut-out, and revision surgery. The study was performed at a level 1 trauma center. All patients who were treated with proximal femoral nailing surgery with a radiological follow-up of at least 3 months were included. Results Of the 955 patients extracted, a total of 564 patients met the inclusion criteria. Second-year residents had significantly higher cut-out rates (p = 0.012). Further analysis indicated a correlation between level of training and surgery duration (p < 0.001) as well as a correlation between surgery duration and infection rate (p < 0.001). The overall complication rate was 11.2%. Analyzing overall complications, no significant difference was found when comparing surgeon groups (p = 0.3). No statistically significant difference was found concerning infection (p = 0.6), cut-out (p = 0.7), and revision surgery (p = 0.3) either. Conclusion Complication rates after proximal femoral nailing are not higher in patients who are treated by residents. Therefore, proximal femoral nailing is an excellent procedure for general orthopedic training. However, we must keep in mind that accurate positioning of the femoral neck screw is essential to keep cut-out rates as low as possible. Level of Evidence III. |
| first_indexed | 2024-03-11T12:39:00Z |
| format | Article |
| id | doaj.art-c5114cb434e842aa922d75ab748a8b16 |
| institution | Directory Open Access Journal |
| issn | 1590-9999 |
| language | English |
| last_indexed | 2024-03-11T12:39:00Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-c5114cb434e842aa922d75ab748a8b162023-11-05T12:26:28ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992023-11-012411610.1186/s10195-023-00737-zComplication rates after proximal femoral nailing: does level of training matter?D. J. Haslhofer0J. M. Stiftinger1N. Kraml2F. Dannbauer3C. Schmolmüller4T. Gotterbarm5O. Kwasny6A. Klasan7Department for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital LinzDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital LinzFaculty of Medicine, Johannes Kepler University LinzDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital LinzDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital LinzDepartment for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital LinzDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital LinzFaculty of Medicine, Johannes Kepler University LinzAbstract Background Surgical treatment of pertrochanteric fractures is one of the most performed surgeries in orthogeriatrics. Proximal femoral nailing, the most performed procedure, is often used as a training surgery for young residents. The objective of this study was to evaluate the relevance of the resident’s training level to complication rates. Material and methods This study was a retrospective cohort study. Surgeons were divided into four groups according to their training level. Complications included infection, cut-out, and revision surgery. The study was performed at a level 1 trauma center. All patients who were treated with proximal femoral nailing surgery with a radiological follow-up of at least 3 months were included. Results Of the 955 patients extracted, a total of 564 patients met the inclusion criteria. Second-year residents had significantly higher cut-out rates (p = 0.012). Further analysis indicated a correlation between level of training and surgery duration (p < 0.001) as well as a correlation between surgery duration and infection rate (p < 0.001). The overall complication rate was 11.2%. Analyzing overall complications, no significant difference was found when comparing surgeon groups (p = 0.3). No statistically significant difference was found concerning infection (p = 0.6), cut-out (p = 0.7), and revision surgery (p = 0.3) either. Conclusion Complication rates after proximal femoral nailing are not higher in patients who are treated by residents. Therefore, proximal femoral nailing is an excellent procedure for general orthopedic training. However, we must keep in mind that accurate positioning of the femoral neck screw is essential to keep cut-out rates as low as possible. Level of Evidence III.https://doi.org/10.1186/s10195-023-00737-zComplication ratePertrochanteric fractureResident trainingRevision surgeryOrthogeriatricsProximal femoral nailing |
| spellingShingle | D. J. Haslhofer J. M. Stiftinger N. Kraml F. Dannbauer C. Schmolmüller T. Gotterbarm O. Kwasny A. Klasan Complication rates after proximal femoral nailing: does level of training matter? Journal of Orthopaedics and Traumatology Complication rate Pertrochanteric fracture Resident training Revision surgery Orthogeriatrics Proximal femoral nailing |
| title | Complication rates after proximal femoral nailing: does level of training matter? |
| title_full | Complication rates after proximal femoral nailing: does level of training matter? |
| title_fullStr | Complication rates after proximal femoral nailing: does level of training matter? |
| title_full_unstemmed | Complication rates after proximal femoral nailing: does level of training matter? |
| title_short | Complication rates after proximal femoral nailing: does level of training matter? |
| title_sort | complication rates after proximal femoral nailing does level of training matter |
| topic | Complication rate Pertrochanteric fracture Resident training Revision surgery Orthogeriatrics Proximal femoral nailing |
| url | https://doi.org/10.1186/s10195-023-00737-z |
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