227 / 245
DOS Kongressen 2016 ·
227
Hip fractures - experiences from the Patient
Compensation Association and suggestions to
improvements in treatment
Niels Jørgen Thomsen, Kim Lyngby Mikkelsen, Christian Wong
Ortopædkirurgisk afd., Hvidovre Hospital; , Patienterstatningen;
Ortopædkirurgisk afd., Hvidovre Hospital
Background:
Proximal femoral fractures are one of the most common type
of fractures worldwide, and are also a large portion of claims in the Patient
Compensation Association (PCA)
Purpose / Aim of Study:
The purpose of the study was to investigate the
claims an desicions on proximal femoral fractures made to the PCA from 2006-
13. We wanted to examine whether there were an association between types
of fractures, severity of the complications, experience level of the physician and
the awarded compensation.
Materials and Methods:
The PCA database of was searched for ICD-10 di-
agnoses DS70.0, DS72.0, DS72.1 and DS72.2. All age groups were included. A
root cause analysis was performed on the data.
Findings / Results:
The number of claims was 723 with a male:female ratio
of 1:3. The average age was 65.9 years. The distribution was 3.5:1.5:1:1 for
Collum (CF), pertrochanteric (PF) , subtrochanteric (SF) and ‘contusion’ frac-
tures. The main complications were improper or insufficient treatment or missed
diagnosis. Pseudoarthrosis was overrepresented for fractures initially diagnosed
as contusion, infection for PF, and CF had cases of nerve and vessel injury. Based
on DPA data, the level of competence was distributed between staff members
and junior residents in the ratio 5:1. One third of all claims were acknowledged
with a distribution of Lex Maria into two almost equal groups; no or light to
moderate damage. 7% suffered severe damage or death. A total of 3,94 mio
EUR was awarded with an avaerage of 12.300 EU .
Conclusions:
The acknowledged claims indicate a need for education on all lev-
els of competence, as the highest level of experience was over represented. One
should have: Special attention for the STF, as missed diagnosis was largely over
represented, and increased attention in surgical technique for CF due to severe
iatrogenic damage.
No conflicts of interest reported
178.