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Udviklingen i behandlingen af intrakapsulære femurfrakturer i Danmark 1996-2007

Reservelæge Tine Jochewet Ravn Dimon & overlæge Jens Ole Laursen Østergårds Alle 49, 5250 Odense SV
Ugeskr Læger 2008;170(38):2949-2953
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Summary Treatment of intracapsular femoral fractures in Denmark from 1996 to 2007 Ugeskr Læger 2008;170(38):2949-2953 Introduction: The treatment of medial collum femoris fractures (MCFF) is a topic for discussion. Recommendations favour internal fixation at all four levels of displacement (Garden type I-IV) for patients younger than 75 years. Older patients with undisplaced fractures (Garden type I-II) are being offered internal fixation, while arthroplasty is offered to patients with displaced fractures (Garden type III-IV). The aim of the present survey is to map the extent and the development in the use of the above mentioned methods in Denmark. Methods: A questionnaire was distributed to all 39 emergency wards in Denmark. The results were compared with those of a similar survey from 1996. Results: In the period 1996-2007, the number of wards treating MCFF was reduced by 50%. In 2007 only a single mixed surgery ward remained compared with 14 in 1996. Garden type I fractures were treated with internal fixation in 77% of the wards and conservatively in 8%. In 1996, 60% were offered surgery. Garden type II fractures were treated with internal fixation in all wards in 2007 as well as in 1996. Garden type III fractures were treated with internal fixation in 12% of the wards, while 81% of the wards offered age-graduated treatment. Garden type IV fractures were treated with internal fixation in one among 26 wards, 81% performs treatment according to the above standards. The period 1996 to 2007 has seen a 12-13% decrease in the number of patients with displaced MCFF who are offered age-graduated treatment. Conclusion: International recommendations seem to have been accepted widely in Danish orthopaedic wards. Nearly all wards currently offer age-graduated treatment.
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