Routine follow-up is unnecessary after intramedullary fixation of trochanteric femoral fractures—Analysis of 995 cases

• Published in: Injury Vol. 51; no. 6; pp. 1343 - 1345
• Main Authors: Halonen, Lauri M., Vasara, Henri, Stenroos, Antti, Kosola, Jussi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2020
• Subjects: Adult; Aged; Aged, 80 and over; Female; Finland - epidemiology; Follow-up; Follow-Up Studies; Fracture Fixation, Intramedullary - economics; Fracture Fixation, Intramedullary - rehabilitation; Fracture Healing; Hip fracture; Hip Fractures - economics; Hip Fractures - rehabilitation; Hip Fractures - surgery; Humans; Male; Middle Aged; Office Visits - economics; Office Visits - statistics & numerical data; Outcome Assessment, Health Care; Outpatients; Postoperative Care - economics; Postoperative Care - statistics & numerical data; Radiography - statistics & numerical data; Treatment Outcome; Trochanteric fracture; Unnecessary Procedures - economics; Unnecessary Procedures - statistics & numerical data; Young Adult; Finland; Hip fracture; Trochanteric fracture; Follow-up
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2020.03.033

•Routine follow-up after trochanteric fracture is a burden to the patients and health care system, with less than 1% leading to changes in treatment.•Large scale efforts should be conducted to optimize the hip fracture postoperative treatment.•The role of routine follow-up visits has been questioned in many different fracture types.•9 of 995 patients required a change in treatment plan due to the findings on planned visits.•We discourage the use of routine follow-up visits for patients with an intramedullary fixation of a trochanteric fracture.
Approximately 2000 trochanteric fractures are operated in Finland annually. These fractures make a major burden to health care system and affected individuals. The role of routine follow-up has been questioned in multiple fracture types.
We analyzed routine follow-up visits after intramedullary fixation of trochanteric fractures (n = 995). Patients were followed up from patient registries until 2 years or death. Planned and unplanned follow-up visits were analyzed.
Altogether 9 patients (0.9%) had a change in treatment at planned outpatient visit. 6 of these were due to mechanical complication, 1 due to refracture and 2 due to delayed unions. 64 (6.4%) patients had a change in treatment plan because of an unplanned visit: 28 infections, 6 pressure sores, 15 mechanic complications and 14 refractures and 1 AVN, respectively.
Routine follow-up visits are a burden both to the patients and health care system, with less than 1% leading to changes in treatment. Our suggestion is to give good instructions to patients and rehabilitation facilities instead of routine follow-up.