title: Evaluation of a routine follow-up visit after an internal fixation of proximal femoral fracture.
abstract: OBJECTIVE
  Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources.
  
  
  METHODS
  A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013. We noted any changes in the patients' treatment plans based on the first follow-up visits, including scheduled visits up to ten weeks after internal fixation.
  
  
  RESULTS
  None of the patients showed signs of infection, implant failure or loss of reduction requiring re-operation at the scheduled follow-up visit. In only one (0.23%) visit a change in treatment plan was made as a result of the scheduled follow-up visit (decision to remove the distal screws from the long intramedullary nail to obtain dynamic compression). Scheduled visits did not occur for the following reasons, death (11.8%), visit to emergency department prior scheduled visit (3.2%), and not known (3.9%).
  
  
  CONCLUSIONS
  The first scheduled visit within ten weeks after internal fixation of a proximal femoral fracture leads to no changes in treatment. We recommend considering the need of these follow-up visits.
authors.affiliation: Trauma unit, Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki, Finland; Academic Medical Centre Helsinki, Helsinki, Finland.
authors.forename: Joonas Mm
authors.initials: JM
authors.lastname: Kuorikoski
authors.affiliation: Trauma unit, Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki, Finland; Academic Medical Centre Helsinki, Helsinki, Finland. Electronic address: tim.soderlund@helsinki.fi.
authors.forename: Tim P
authors.initials: TP
authors.lastname: Söderlund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000191:economics / Q000534:rehabilitation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000191:economics / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D011182:Postoperative Care / Q000191:economics / Q000706:statistics & numerical data; D011859:Radiography / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Complication; Control visit; Follow-up visit; Hip fracture; Internal fixation; Outpatient visit; Proximal femur fracture