{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:26:10Z","timestamp":1793748370120,"version":"4.6.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Surgeon fatigue is a recognized risk factor for patient safety; however, reduced working hours may limit surgical training exposure. In 2005, Switzerland introduced a maximum 50-hour workweek for resident surgeons. In view of current discussions on further reductions (42\u2009+\u20094\u00a0h), concerns persist regarding training quality and workforce capacity. This study evaluates the impact of the 2005 Swiss labor law on patient outcomes, operative characteristics, and intraoperative teaching utilizing a standardized trauma procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of anonymized data from a national database was performed. All patients undergoing operative fixation of trochanteric femur fractures (ICD-10 S72.1) were included. Two four-year periods were compared: pre-regulation (2001\u20132004) and post-regulation (2016\u20132019). Primary endpoints were in-hospital complications, mortality, and length of stay. Secondary endpoints included patient characteristics, surgeon seniority, teaching status, operative duration, and time to surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Post-regulation patients were older and exhibited higher American Society of Anesthesiologists classifications despite fewer comorbidities. Complications increased from 9.1% to 17.7%, and mortality from 1.6% to 3.5%. Length of stay decreased from 14 to 9 days. Operative duration decreased by 10\u00a0min across all surgeon levels. Resident surgeons independently performed 10% fewer procedures, but teaching operations increased significantly among resident surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following the introduction of working hour limitations, supervised teaching increased substantially. Although complication and mortality rates rose\u2014likely reflecting an older and more complex patient population\u2014hospital stays shortened. The proposed 42\u2009+\u20094-hour model will require targeted compensatory measures to maintain surgical training quality and patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03204-6","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:42:33Z","timestamp":1778661753000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in operative and in-hospital outcome of proximal femoral fractures before and after the implementation of work hour restrictions in Switzerland"],"prefix":"10.1007","volume":"52","author":[{"given":"Alexandra","family":"Tewes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6486-2481","authenticated-orcid":false,"given":"Claudio","family":"Canal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Othmar","family":"Sch\u00f6b","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4012-5628","authenticated-orcid":false,"given":"Valentin","family":"Neuhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"3204_CR1","doi-asserted-by":"crossref","unstructured":"Reijmerink IM et al. 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Thus, no ethical approval is required.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Financial interests: The authors declare that they have no competing financial interests. Nonfinancial interests: Valentin Neuhaus is chair of the board of the AQC, and Claudio Canal and Othmar Sch\u00f6b are on the advisory board of directors of the AQC. They receive no compensation as members of the board of directors.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"166"}}