ArticlePloS one2022
The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Assessing Impact of Orthopedic Subspecialty Training on Outcomes of Non-Arthroplasty Fixation of Geriatric Hip Fractures.Hip & pelvis · 2026Article
- Letter to the Editor: "Outcome of femoral fractures treated with cerclages and intramedullary Nailing".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- The Correlation of Surgeon Subspecialty With Outcomes Following Surgery for Geriatric Femoral Neck Fracture.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Comparing the post-operative complications following surgery for hip fracture of patients who were on warfarin versus patients who were on novel oral anticoagulants: a meta-analysis.Perioperative medicine (London, England) · 2025Article
- Predictors of Venous Thromboembolism Following Geriatric Distal Femur Fracture Fixation: Are These Patients at Higher Risk Compared With Hip Fracture Patients?Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Trends and Complications of Hip Fracture Fixation Among Early Career Orthopaedic Surgeons: An Analysis of the American Board of Orthopaedic Surgery Part II Oral Examination Database.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Navigated intramedullary nailing for patients with intertrochanteric hip fractures is cost-effective at high-volume hospitals in mainland China: A markov decision analysis.Frontiers in surgery · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introductionAmerican orthopaedists are increasingly seeking fellowship sub-specialization. One proposed benefit of fellowship training is decrease in complications, however, few studies have investigated the rates of medical and surgical complications for hip fracture patients between orthopedists from different fellowship backgrounds. This study aims to investigate the effect of fellowship training and case volume on medical and surgical outcomes of patient following hip fracture surgical intervention.
methods1999-2016 American Board of Orthopedic Surgery (ABOS) Part II Examination Case List data were used to assess patients treated by trauma or adult reconstruction fellowship-trained orthopedists versus all-other orthopaedists. Rates of surgeon-reported medical and surgical adverse events were compared between the three surgeon cohorts. Using binary multivariate logistic regression to control of demographic factors, independent factors were evaluated for their effect on surgical complications.
resultsData from 73,427 patients were assessed. An increasing number of hip fractures are being treated by trauma fellowship trained surgeons (9.43% in 1999-2004 to 60.92% in 2011-2016). In multivariate analysis, there was no significant difference in type of fellowship, however, surgeons with increased case volume saw significantly decreased odds of complications (16-30 cases: OR = 0.91; 95% CI: 0.85-0.97; p = 0.003; 31+ cases: OR = 0.68; 95% CI: 0.61-0.76; p<0.001). Femoral neck hip fractures were associated with increased odds of surgical complications. DISCUSSION: Despite minor differences in incidence of surgical complications between different fellowship trained orthopaedists, there is no major difference in overall risk of surgical complications for hip fracture patients based on fellowship status of early orthopaedic surgeons. However, case volume does significantly decrease the risk of surgical complications among these patients and may stand as a proxy for fellowship training. Fellows required to take hip fracture call as part of their training regardless of fellowship status exhibited decreased complication risk for hip fracture patients, thus highlighting the importance of additional training.
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