{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:57:53Z","timestamp":1785463073800,"version":"3.56.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Hip fractures are among the most common orthopaedic injuries and are a vital element of orthopaedic surgery residency training. Multiple studies have examined resident involvement on surgical time, length of stay (LOS), cost, and outcomes. This study compared the time from orthopaedic hip fracture consultation to operative fixation before and after implementation of a new orthopaedic residency at a rural community hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of electronic medical records was performed for patients who underwent surgical fixation of a hip fracture from July 2019 to June 2023. July 2019 to June 2021 represented the period before orthopaedic residents, and July 2021 to June 2023 represented the period with orthopaedic resident involvement. The primary outcome was time from hip fracture consult order to patient entry into the operating room (OR) before and after resident involvement. Secondary outcomes included LOS, 30-day readmission rate, and 90-day return to the emergency department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 821 hip fractures underwent operative fixation between July 2019 and June 2023: 387 (47.1%) were performed before resident involvement and 434 (52.9%) were performed after initiation of the orthopaedic residency. There was no statistically significant difference in time to OR from consult before and after resident involvement (28.3 vs. 27.8 hours, p = 0.786), LOS (6.4 vs. 6.1 days, p = 0.33), 30-day readmission rate (12.1% vs. 9.9%, p = 0.362), or 90-day return to the emergency department (26.1% vs. 27.4%, p = 0.728).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Timely hip fracture fixation within 24 to 48 hours is essential for optimal patient outcomes. This study demonstrates that the introduction of orthopaedic surgery residents does not compromise timely operative fixation, LOS, or readmission rates in patients with hip fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.25.00029","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:00:24Z","timestamp":1784325624000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of New Orthopaedic Surgery Residency on Hip Fracture Time to Fixation at Rural Level 1 Trauma Center"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-9119","authenticated-orcid":false,"given":"Justin","family":"MacDonald","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Wardell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-5813","authenticated-orcid":false,"given":"Oliver","family":"Sogard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4296-4561","authenticated-orcid":false,"given":"Joseph","family":"Yee","sequence":"additional","affiliation":[{"name":"Lake Erie College of Medicine, Elmira, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter","family":"Whittemore","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7339-1937","authenticated-orcid":false,"given":"Jeffrey","family":"Lutton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Behm","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Guthrie Clinic, Sayre, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"issue":"3","key":"R1-20260731","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1359\/jbmr.061113","article-title":"Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025","volume":"22","author":"Burge","year":"2007","journal-title":"J Bone Miner Res."},{"issue":"8","key":"R2-20260731","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.injury.2018.04.015","article-title":"Epidemiology and social costs of hip fracture","volume":"49","author":"Veronese","year":"2018","journal-title":"Injury."},{"issue":"252","key":"R3-20260731","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/00003086-199003000-00024","article-title":"The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen","volume":"252","author":"Cummings","year":"1990","journal-title":"Clin Orthop Relat Res."},{"issue":"20","key":"R5-20260731","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1001\/jama.2017.17606","article-title":"Association between wait time and 30-day mortality in adults undergoing hip fracture surgery","volume":"318","author":"Pincus","year":"2017","journal-title":"JAMA."},{"issue":"2","key":"R8-20260731","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2106\/JBJS.16.01611","article-title":"Resident participation in fixation of intertrochanteric hip fractures: analysis of the NSQIP database","volume":"100","author":"Neuwirth","year":"2018","journal-title":"J Bone Joint Surg."},{"issue":"4","key":"R9-20260731","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jcot.2016.02.002","article-title":"The impact of resident involvement on outcomes in orthopedic trauma: an analysis of 20,090 cases","volume":"7","author":"Mitchell","year":"2016","journal-title":"J Clin Orthopaedics Trauma."},{"issue":"15","key":"R10-20260731","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.2106\/JBJS.M.00660","article-title":"Impact of resident involvement on orthopaedic surgery outcomes: an analysis of 30,628 patients from the American College of Surgeons National Surgical Quality Improvement Program database","volume":"96","author":"Edelstein","year":"2014","journal-title":"J Bone Joint Surg."},{"issue":"2","key":"R11-20260731","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.surg.2008.03.031","article-title":"Resident versus no resident: a single study on operative complications, mortality, and cost","volume":"144","author":"Hwang","year":"2008","journal-title":"Surgery."},{"issue":"13","key":"R12-20260731","doi-asserted-by":"crossref","first-page":"687","DOI":"10.5435\/JAAOS-D-22-00696","article-title":"The effect of resident involvement in hip fracture surgery: an analysis of a single institution before and after the addition of an orthopaedic surgical residency","volume":"31","author":"Dutcher","year":"2023","journal-title":"J Am Acad Orthop Surg."},{"issue":"2","key":"R13-20260731","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.injury.2017.01.005","article-title":"Predictors of 30-day hospital readmission after hip fracture: a systematic review","volume":"48","author":"Ali","year":"2017","journal-title":"Injury."},{"issue":"4","key":"R14-20260731","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s41999-020-00307-0","article-title":"Process-related predictors of readmissions and mortality following hip fracture surgery: a population-based analysis","volume":"11","author":"Sarimo","year":"2020","journal-title":"Eur Geriatr Med."},{"key":"R15-20260731","doi-asserted-by":"crossref","first-page":"117576","DOI":"10.1016\/j.bone.2025.117576","article-title":"Unplanned emergency room visits within 30 and 90 days after osteoporotic hip fracture surgery: a comprehensive risk factor analysis","volume":"199","author":"Kim","year":"2025","journal-title":"Bone."},{"issue":"2","key":"R16-20260731","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.afos.2024.05.005","article-title":"Unplanned emergency department visits within 90 days of hip hemiarthroplasty for osteoporotic femoral neck fractures: reasons, risks, and mortalities","volume":"10","author":"Wang","year":"2024","journal-title":"Osteoporos Sarcopenia."},{"issue":"5","key":"R17-20260731","first-page":"e21.00073","article-title":"Risk factors associated with extended length of hospital stay after geriatric hip fracture","volume":"5","author":"Schneider","year":"2021","journal-title":"JAAOS"}],"container-title":["JBJS Open Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.25.00029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:01:46Z","timestamp":1785459706000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.25.00029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.oa.25.00029","relation":{},"ISSN":["2472-7245"],"issn-type":[{"value":"2472-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}