AB119. SOH22ABS043. Irish hip fracture fixation trends over a 7-year period and international registry comparison

Background: Hip fractures are a significant cause of morbidity and mortality in elderly patients. Timely surgical fixation and early mobilisation are the cornerstone to successful outcomes. The Irish Hip Fracture Database (IHFD) was established in 2012 and publishes annual reports on hip fracture care. This paper describes the trends in surgical fixation in Ireland during a 7-year period (2013–2019), assesses for compliance with guidelines and compares the most recent published reports from ten international hip fracture registries.

Methods: All published IHFD reports were systematically reviewed and tabulated. Data including fracture type, surgical fixation and post-operative management was plotted and analysed using descriptive statistics. Ten international hip fracture registries were also identified and reviewed.

Results: A total of 21,684 hip fractures were recorded during this period. The majority of patients were female (70.16%), >80 years old (58.26%), admitted from their own home (82.13%) and ASA grade 3 (53%). The majority of undisplaced and displaced intracapsular fractures were treated with hemiarthroplasty, 62% and 88% respectively. The rate of total hip replacement (THR) for displaced intracapsular fractures has increased to 7%, with increasing rates of cementing of arthroplasties, despite remaining significantly lower than other international registries. There has been a decline in the use of dynamic hip screw (DHS) for intertrochanteric fractures with intramedullary nails being favoured.

Conclusions: Despite greater awareness of hip fracture care through the IHFD and the introduction of Best Practice Tariffs (BPT), further improvements are needed. Ireland compares well to international standards but has low rates of compliance to NICE guidelines for surgical fixation.

Keywords: Audit, orthopaedics; Irish Hip Fracture Database (IHFD); National Office of Clinical Audit; registry