A survey of senior orthopaedic surgeons undertaken by the British Orthopaedic Association has stated that elderly patients face early death and permanent disability because of delays in treating emergency hip fractures, and has identified NHS elective targets as one of the main reasons.
Neck of femur fractures are one of the most common complex trauma problems orthopaedic surgeons face, with 70,000 cases a year, and the number of cases is rising each year. The British Orthopaedic Association recommends surgery within a maximum of 48 hours of the patient being fit for surgery and believes 95% of cases should be treated within this time limit. Mortality rates for these patients run at 10% within a month and 30% within a year of their fracture. The study found:
• More than half of surgeons stated their unit could not manage to operate on 95% of these patients within 48 hours. They estimate that approximately one fifth of these patients have to wait more than 48 hours.
• Lack of specialised geriatric medical support to get patients fit for surgery, low commitment from NHS management and shortages of dedicated theatre time for trauma were cited as main causes.
• More than half of surgeons stated their unit could not manage to operate on 95% of these patients within 48 hours. They estimate that approximately one fifth of these patients have to wait more than 48 hours.
• Lack of specialised geriatric medical support to get patients fit for surgery, low commitment from NHS management and shortages of dedicated theatre time for trauma were cited as main causes.
