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Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair

BACKGROUND: The purpose of this study was to determine the impact of surgeon volume on outcomes following ankle fracture fixation. METHODS: Over 7 years, 362 patients who met inclusion criteria (>18 years with rotational ankle fractures) were identified and treated by orthopaedic surgeons at seve...

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Autores principales: Deemer, Alexa R., Drake, Jack H., Littlefield, Connor P., Egol, Kenneth A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421026/
https://www.ncbi.nlm.nih.gov/pubmed/36046553
http://dx.doi.org/10.1177/24730114221116790
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author Deemer, Alexa R.
Drake, Jack H.
Littlefield, Connor P.
Egol, Kenneth A.
author_facet Deemer, Alexa R.
Drake, Jack H.
Littlefield, Connor P.
Egol, Kenneth A.
author_sort Deemer, Alexa R.
collection PubMed
description BACKGROUND: The purpose of this study was to determine the impact of surgeon volume on outcomes following ankle fracture fixation. METHODS: Over 7 years, 362 patients who met inclusion criteria (>18 years with rotational ankle fractures) were identified and treated by orthopaedic surgeons at several hospitals within an academic medical center and were retrospectively reviewed. Surgeons that completed less than 24 ankle fixations per year (<90th percentile) during the study period were classified as low-volume (LV) and surgeons completing 24 or more ankle fixations per year (>90th percentile) were classified as high-volume (HV). Chart review was conducted to gather data regarding perioperative, radiographic, inpatient, and long-term outcome data (average 12-month follow-up). RESULTS: One hundred thirty-four patients (37.0%) were treated by LV surgeons and 228 (63.0%) were treated by HV surgeons. Although both cohorts had a similar breakdown of fracture patterns (P = .638), the LV cohort had a greater incidence of open fractures (P = .024). No differences were found regarding wait time to surgery, surgery duration, and LOS. Radiographically, more patients in the HV cohort achieved anatomic mortise after surgery (96.5% vs 89.6%, P = .008). Patients in the LV cohort took longer to heal radiographically (4.27 ± 2.4 months vs 5.59 ± 2.9 months, P < .001), and also had higher rates of reoperation and hardware removal (P < .05). Lastly, all cost variables were lower for high-volume surgeons (P < .05). CONCLUSION: In this single-center study, we found that patients treated by LV surgeons took 30% longer to heal radiographically and had greater reoperation rates than those treated by HV surgeons. Additionally, patients treated by high-volume surgeons had more anatomic postoperative radiographic ankle mortise reductions and was less cost-effective than when performed by high-volume surgeons. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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spelling pubmed-94210262022-08-30 Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair Deemer, Alexa R. Drake, Jack H. Littlefield, Connor P. Egol, Kenneth A. Foot Ankle Orthop Article BACKGROUND: The purpose of this study was to determine the impact of surgeon volume on outcomes following ankle fracture fixation. METHODS: Over 7 years, 362 patients who met inclusion criteria (>18 years with rotational ankle fractures) were identified and treated by orthopaedic surgeons at several hospitals within an academic medical center and were retrospectively reviewed. Surgeons that completed less than 24 ankle fixations per year (<90th percentile) during the study period were classified as low-volume (LV) and surgeons completing 24 or more ankle fixations per year (>90th percentile) were classified as high-volume (HV). Chart review was conducted to gather data regarding perioperative, radiographic, inpatient, and long-term outcome data (average 12-month follow-up). RESULTS: One hundred thirty-four patients (37.0%) were treated by LV surgeons and 228 (63.0%) were treated by HV surgeons. Although both cohorts had a similar breakdown of fracture patterns (P = .638), the LV cohort had a greater incidence of open fractures (P = .024). No differences were found regarding wait time to surgery, surgery duration, and LOS. Radiographically, more patients in the HV cohort achieved anatomic mortise after surgery (96.5% vs 89.6%, P = .008). Patients in the LV cohort took longer to heal radiographically (4.27 ± 2.4 months vs 5.59 ± 2.9 months, P < .001), and also had higher rates of reoperation and hardware removal (P < .05). Lastly, all cost variables were lower for high-volume surgeons (P < .05). CONCLUSION: In this single-center study, we found that patients treated by LV surgeons took 30% longer to heal radiographically and had greater reoperation rates than those treated by HV surgeons. Additionally, patients treated by high-volume surgeons had more anatomic postoperative radiographic ankle mortise reductions and was less cost-effective than when performed by high-volume surgeons. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SAGE Publications 2022-08-25 /pmc/articles/PMC9421026/ /pubmed/36046553 http://dx.doi.org/10.1177/24730114221116790 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Deemer, Alexa R.
Drake, Jack H.
Littlefield, Connor P.
Egol, Kenneth A.
Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title_full Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title_fullStr Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title_full_unstemmed Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title_short Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
title_sort surgeon volume impacts outcomes following ankle fracture repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421026/
https://www.ncbi.nlm.nih.gov/pubmed/36046553
http://dx.doi.org/10.1177/24730114221116790
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