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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_5 | Pages 13 - 13
1 Mar 2014
Barksfield R Coomber R Woolf K Prinja A Wordsworth D Lopez D Burtt S
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The Royal College of Surgeons of England (RCS) recently issued guidance regarding the use of re-operation rates in the re-validation of UK based orthopaedic surgeons. Currently, little has been published concerning acceptable rates of re-operation following primary surgical management of orthopaedic trauma, particularly with reference to re-validation.

We conducted a retrospective review of patients undergoing a clearly defined re-operation following primary surgical management of trauma between 1st January 2010 and 31st December 2011. 3688 patients underwent primary procedures while 83 (2.25%; 99%CI = 1.69 to 2.96%) required an unplanned re-operation. The mean age of patients was 46 years (range 2–98) with 46 (55%) males and a median time to re-operation of 34 days (IQR 12–134). Potentially avoidable re-operations occurred in 47 patients (56.6%; 99%CI = 42.6 to 69.8%) largely due to technical errors (46 patients; 55.4%; 99%CI = 41.4 to 68.7%), representing 1.27% (99%CI = 0.87 to 1.83%) of the total trauma workload. Within RCS guidelines 28 day re-operation rates for hip fractures, wrist fractures and ankle fractures were 1.4% (99%CI = 0.5 to 3.3%), 3.5% (99%CI = 0.8% to 12.1%) and 2.48% (99%CI = 0.7 to 7.6%) respectively.

We present novel work that has established baseline re-operation rates for index procedures required for revalidation of orthopaedic surgeons.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 118 - 118
1 Jan 2013
Das A Coomber R Halsey T Ollivere B Johnston P
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Aims

Bone is a common site of metastatic disease. Skeletal complications include disabling pain and pathological fractures. Palliative surgery for incurable metastatic bone lesions aims to preserve quality of life and function by providing pain relief and stable mobility with fixation or replacement.

Current literature has few treatment studies. We present a 5 year longitudinal cohort study of surgery for metastatic bone disease at our large teaching hospital reviewing our complication and mortality rates.

Methods

Patients that underwent palliative surgery for metastatic bone lesions were identified from operative records. Demographics, clinical details and outcomes were recorded. Kaplan-Meier analysis was used to calculate survivorship.