Evaluation of a routine follow-up visit after an internal fixation of proximal femoral fracture.

Abstract

Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013. We noted any changes in the patients' treatment plans based on the first follow-up visits, including scheduled visits up to ten weeks after internal fixation. None of the patients showed signs of infection, implant failure or loss of reduction requiring re-operation at the scheduled follow-up visit. In only one (0.23%) visit a change in treatment plan was made as a result of the scheduled follow-up visit (decision to remove the distal screws from the long intramedullary nail to obtain dynamic compression). Scheduled visits did not occur for the following reasons, death (11.8%), visit to emergency department prior scheduled visit (3.2%), and not known (3.9%). The first scheduled visit within ten weeks after internal fixation of a proximal femoral fracture leads to no changes in treatment. We recommend considering the need of these follow-up visits.