title: Neck of femur fracture management by general surgeons at a rural hospital.
abstract: BACKGROUND
  Neck of femur (NOF) fractures are the most common injury among elderly patients and a significant burden on our healthcare system.
  
  
  OBJECTIVE
  This study aimed toevaluate if an Australian rural hospital serviced by general surgeons can meet the established standards of care for the management of NOF fractures by undertaking surgery within 48 hours.
  
  
  METHODS
  An audit of patients presenting to an Australian rural hospital with NOF fractures over a seven-year period. Patients were excluded if they were transferred or suffered peri-prosthetic or multi-trauma-related fractures. Outcomes included time to surgery, length of stay, and in-hospital mortality, and were compared to three similar Australian studies from hospitals with specialist orthopedic units. Descriptive statistics and meta-analysis were performed.
  
  
  RESULTS
  Overall, 182 patients presented with NOF fractures and 114 met our inclusion criteria. Only 12 per cent of patients were transferred. Patients were mostly female (74 per cent) and elderly (mean age 84.0 years). A total of 79 per cent of patients were operated on within48 hours; other studies reported 67-86 per cent. Mean length of stay was 11.9 days (versus 7.7-13.7), and in-hospital mortality was 4 per cent (versus 2-7 per cent).
  
  
  CONCLUSIONS
  This audit suggests that an Australian rural hospital serviced by general surgeons can meet the established standards of care for management of most NOF fractures. Some post-surgery outcomes are similar to those reported by larger centers with specialized orthopedics units.
authors.affiliation: Hamilton Base Hospital, Western District Health Service, Hamilton, VIC, Australia ; St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
authors.forename: Cristian
authors.initials: C
authors.lastname: Udovicich
authors.affiliation: Hamilton Base Hospital, Western District Health Service, Hamilton, VIC, Australia ; St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
authors.forename: Dean
authors.initials: D
authors.lastname: Page
authors.affiliation: St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia ; Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia ; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia.
authors.forename: Molla
authors.initials: M
authors.lastname: Huq
authors.affiliation: Hamilton Base Hospital, Western District Health Service, Hamilton, VIC, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Clifforth
keywords: Neck of femur; aged care; health outcome; hip fractures; hip surgery; rural health