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DELAY TO SURGERY FOR ACUTE FRACTURES AT AUCKLAND HOSPITAL



Abstract

There has been a growing concern amongst the Orthopaedic Department at Auckland Hospital regarding the time Orthopaedic acute patients are waiting for surgery. To address this concern this study was undertaken to examine the extent of the problem and to establish recommended practice guidelines for waiting times.

A literature search was undertaken to identify universally accepted delays for surgery for the six categories of fracture studied – compound fractures, femoral shaft fractures, tibial shaft fractures, ankle fractures, neck of femur fractures and distal radial fractures. Current practise guidelines were then compared with the literature to ensure they are an acceptable standard of care. Every patient operated on at Auckland Hospital in 2002 that had a fracture that fell within the six categories was included in the study. Data regarding the age and time to surgery for each patient was analysed.

The study demonstrated major discrepancies between recommended practise guidelines and the present acute service. The general trend is that the more acute the fracture, the less likely it is to be operated on within the guidelines.

Further investigation should be undertaken to look at reasons behind the delays and ways to improve access. This will assist in identifying responsibility for ensuring that an acceptable standard of care is maintained.

The abstracts were prepared by Jean-Claude Theis. Correspondence should be addressed to him at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.