title: The epidemiology of reoperations for orthopaedic trauma.
abstract: BACKGROUND
  The Royal College of Surgeons of England (RCS) has issued guidance regarding the use of reoperation rates in the revalidation of UK-based orthopaedic surgeons. Currently, little has been published concerning acceptable rates of reoperation following primary surgical management of orthopaedic trauma, particularly with reference to revalidation.
  
  
  METHODS
  A retrospective review was conducted of patients undergoing clearly defined reoperations following primary surgical management of trauma between 1 January 2010 and 31 December 2011. A full case note review was undertaken to establish the demographics, clinical course and context of reoperation. A review of the imaging was performed to establish whether the procedure performed was in line with accepted trauma practice and whether the technical execution was acceptable.
  
  
  RESULTS
  A total of 3,688 patients underwent primary procedures within the time period studied while 70 (1.90%, 99% CI: 1.39-2.55) required an unplanned reoperation. Thirty-nine (56%) of these patients were male. The mean age of patients was 56 years (range: 18-98 years) and there was a median time to reoperation of 50 days (IQR: 13-154 days). Potentially avoidable reoperations occurred in 41 patients (58.6%, 99% CI: 43.2-72.6). This was largely due to technical errors (40 patients, 57.1%, 99% CI: 41.8-71.3), representing 1.11% (99% CI: 0.73-1.64) of the total trauma workload. Within RCS guidelines, 28-day reoperation rates for hip, wrist and ankle fractures were 1.4% (99% CI: 0.5-3.3), 3.5% (99% CI: 0.8%-12.1) and 1.86% (99% CI: 0.4-6.6) respectively.
  
  
  CONCLUSIONS
  We present novel work that has established baseline reoperation rates for index procedures required for revalidation of orthopaedic surgeons.
authors.affiliation: Luton and Dunstable Hospital NHS Foundation Trust, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Barksfield
authors.forename: R
authors.initials: R
authors.lastname: Coomber
authors.forename: K
authors.initials: K
authors.lastname: Woolf
authors.forename: A
authors.initials: A
authors.lastname: Prinja
authors.forename: D
authors.initials: D
authors.lastname: Wordsworth
authors.forename: D
authors.initials: D
authors.lastname: Lopez
authors.forename: S
authors.initials: S
authors.lastname: Burtt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult