Trauma audit in Srinagarind Hospital: improvement strategies for the treatment of mid-shaft femoral fractures.

Abstract

Abstract

Objective:  To study trauma audit in mid-shaft femoral fractures in Srinagarind hospital.

Study Design: Prospective, descriptive study.

Setting: Accident & Emergency (A&E) Unit in Srinagarind hospital, Faculty of Medicine, Khon Kaen University.

Patients and Methods: All patients who had injuries in the A&E unit total 3,000 cases during January 1, 2006 and May 31, 2006.  Fractures of mid-shaft of the femur were selected.

Data Collection: Trauma audit recording form developed by A&E Unit, database of trauma registry, inpatient medical records and card for the medical records

Measurement: Descriptive statistics, including number, percentages and means.

Results: In total trauma cases of 3,000, there were 129 cases of fracture of the lower extremities. Eighty were admit for treatment. Fractures of mid-shaft of the femur were diagnosed in 8 patients (9 femurs which one patient had bilateral femoral fractures). All patients who had femoral fractures were operated and fixed, pass the trauma audit filter. However, in cases of multiple fractures or multiple injuries spent longer period in the resuscitation room than the standard time that suggested. In severe cases, Injury Severity Score (ISS) > 27 had longer hospital stay, mean18.5 days, compared with non-severe cases ISS <13, mean 9 days. Multiple Injuries had abdominal injuries from liver laceration and repaired. All fracture of femur patients were survived and had no serious complication.

Conclusion: Trauma audit in fracture of mid-shaft of the femur is important in case of serious injuries. Multiple injuries, multiple fractures or severe injuries should be assessed as quickly as possible in order to resuscitate or do the emergency procedures. It will reduce the death and complications that can be prevented. Hospital stay is related to the severity of injuries.

Keywords: Trauma audit, mid-shaft femoral fracture.