Routine follow-up is unnecessary after intramedullary fixation of trochanteric femoral fractures-Analysis of 995 cases.

Abstract

Approximately 2000 trochanteric fractures are operated in Finland annually. These fractures make a major burden to health care system and affected individuals. The role of routine follow-up has been questioned in multiple fracture types. We analyzed routine follow-up visits after intramedullary fixation of trochanteric fractures (n = 995). Patients were followed up from patient registries until 2 years or death. Planned and unplanned follow-up visits were analyzed. Altogether 9 patients (0.9%) had a change in treatment at planned outpatient visit. 6 of these were due to mechanical complication, 1 due to refracture and 2 due to delayed unions. 64 (6.4%) patients had a change in treatment plan because of an unplanned visit: 28 infections, 6 pressure sores, 15 mechanic complications and 14 refractures and 1 AVN, respectively. Routine follow-up visits are a burden both to the patients and health care system, with less than 1% leading to changes in treatment. Our suggestion is to give good instructions to patients and rehabilitation facilities instead of routine follow-up.