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. 2015 Jan;97(1):40-5.
doi: 10.1308/003588414X14055925059318.

The epidemiology of reoperations for orthopaedic trauma

R C Barksfield  1 , R Coomber, K Woolf, A Prinja, D Wordsworth, D Lopez, S Burtt
Affiliations

The epidemiology of reoperations for orthopaedic trauma

R C Barksfield et al. Ann R Coll Surg Engl. 2015 Jan.

Abstract

Introduction: The Royal College of Surgeons of England (RCS) has issued guidance regarding the use of reoperation rates in the revalidation of UK-based orthopaedic surgeons. Currently, little has been published concerning acceptable rates of reoperation following primary surgical management of orthopaedic trauma, particularly with reference to revalidation.

Methods: A retrospective review was conducted of patients undergoing clearly defined reoperations following primary surgical management of trauma between 1 January 2010 and 31 December 2011. A full case note review was undertaken to establish the demographics, clinical course and context of reoperation. A review of the imaging was performed to establish whether the procedure performed was in line with accepted trauma practice and whether the technical execution was acceptable.

Results: A total of 3,688 patients underwent primary procedures within the time period studied while 70 (1.90%, 99% CI: 1.39-2.55) required an unplanned reoperation. Thirty-nine (56%) of these patients were male. The mean age of patients was 56 years (range: 18-98 years) and there was a median time to reoperation of 50 days (IQR: 13-154 days). Potentially avoidable reoperations occurred in 41 patients (58.6%, 99% CI: 43.2-72.6). This was largely due to technical errors (40 patients, 57.1%, 99% CI: 41.8-71.3), representing 1.11% (99% CI: 0.73-1.64) of the total trauma workload. Within RCS guidelines, 28-day reoperation rates for hip, wrist and ankle fractures were 1.4% (99% CI: 0.5-3.3), 3.5% (99% CI: 0.8%-12.1) and 1.86% (99% CI: 0.4-6.6) respectively.

Conclusions: We present novel work that has established baseline reoperation rates for index procedures required for revalidation of orthopaedic surgeons.

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Figures

Figure 1
Figure 1
Royal College of Surgeons of England revalidation criteria for hip fractures
Figure 2
Figure 2
Royal College of Surgeons of England revalidation criteria for index trauma procedures
Figure 3
Figure 3
Distribution of reoperation procedures performed in 2010 and 2011 by anatomical site (n=70)
Figure 4
Figure 4
Reoperation free survival from primary procedure at 28 days and at 168 days (n=70)
See this image and copyright information in PMC

References

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