{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:41:12Z","timestamp":1790930472301,"version":"4.1.0"},"reference-count":89,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Investigation of the treatment of femur fractures and the type of femur fracture\u2010associated complications regarding timing of surgery and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study, a total of 358 hip fractures were evaluated retrospectively from 1 January 2008 until 31 December 2010 at a level I trauma center in Germany. Inclusion criteria was age &gt;18\u2009years and a proximal femur fracture. Both sexes were evaluated. Mean age was 75.5\u2009years, most patients were female (63.7%). Intervention was the operative treatment of proximal femur fracture. Outcome parameters were time until surgery, complications, reoperations, mortality, and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the proximal femur fractures (<jats:italic>n<\/jats:italic> = 358), 46.6% were pertrochanteric, 11.2% subtrochanteric, and 42.2% femoral neck fractures. Operation upon hip fractures was managed regularly within 24\u2009hours of injury (73%; mean for femoral neck: 28.3 hrs.; mean for pertrochanteric fractures: 21.4 hrs.; mean for subtrochanteric fractures: 19.5 hrs.). Delayed treatment, as well as implantation of hip total endoprosthesis (TEP), increased the overall length of hospital stay (15.4 <jats:italic>vs<\/jats:italic> 17.6\u2009days; 18.1 <jats:italic>vs<\/jats:italic> 15.8\u2009days). Accordingly, surgical procedures performed within 24\u2009hours of injury resulted in a shorter hospital residence. Longest delay of operation was measured for hip fractures (28.3 hrs.).<\/jats:p><jats:p>In 351 patients, secondary injuries were detected in 94 individuals (26%), with fractures being the most common secondary injury (<jats:italic>n<\/jats:italic> = 40). We recorded postoperative complications of nonsurgical and surgical origin, and 33.6% of our patient cohort displayed complications. Complications were distributed among 118 patients. There was no significant difference in complications regarding the time of operation, with most nonsurgical and surgical complications appearing within 24\u2009hours after operation (<jats:italic>n<\/jats:italic> = 110 <jats:italic>vs n<\/jats:italic> = 31). Nonsurgical complications, such as anemia (<jats:italic>n<\/jats:italic> = 49) and electrolyte imbalances (<jats:italic>n<\/jats:italic> = 30), were observed more frequently than surgical complications (<jats:italic>n<\/jats:italic> = 107 <jats:italic>vs n<\/jats:italic> = 34); however, these complications were reduced by delay in surgery (82.0% in 6\u201324 hrs. <jats:italic>vs<\/jats:italic> 74.2% in \u226524 hrs.). Anticoagulant therapy and age did not affect postoperative complications. The hospital mortality of patients was 6.2%. Follow\u2010up was restrained to ambulatory visits in the clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgical management of hip fractures performed within 24\u2009hours of injury minimizes hospital stay. We did not detect significant differences in the spectrum or number of complications regarding delay of surgery. Surgical complications mainly occur with rapid primary care, and medical complications can be reduced by more intensive preparation of patient and operation procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12524","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T05:24:12Z","timestamp":1569907452000},"page":"994-1002","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["Hip Fractures: Therapy, Timing, and Complication Spectrum"],"prefix":"10.1111","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0673-3710","authenticated-orcid":false,"given":"Dominik","family":"Saul","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics, and Plastic Surgery University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Riekenberg","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics, and Plastic Surgery University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan C","family":"Ammon","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics, and Plastic Surgery University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics, and Plastic Surgery University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Sehmisch","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics, and Plastic Surgery University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Gesundheit und Krankheit im Alter","author":"B\u00f6hm K","year":"2009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-926637"},{"key":"e_1_2_7_4_1","first-page":"1751","article-title":"Schenkelhalsfrakturen in Deutschland: Pr\u00e4vention, Therapie, Inzidenz und sozio\u00f6konomische Bedeutung","volume":"98","author":"Minne HW","year":"2001","journal-title":"Dtsch Arztebl"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001040051045"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0534-6"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1298299"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.017714"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2015.04.032"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2014.02.016"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-010-1004-x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2012.747926"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(89)90152-6"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-009-1674-2"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B1.35041"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00029"},{"key":"e_1_2_7_17_1","unstructured":"BonnaireW.S2e\u2010Leitlinie 012\/001: Schenkelhalsfraktur des Erwachsenen. 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