• R Smektala, M Wenning, M Luka, and A Ekkernkamp.
• Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum Langendreer, Ruhr Universität Bochum.
• Zentralbl Chir. 2000 Jan 1;125 Suppl 2:211-7.

AbstractA report card system for fractures of the femur neck has been established at the department of external quality assurance of the chamber of physicians of Westphalia-Lippe since 1993. Since then several indicators of good quality have significantly changed: conservative treatment decreased from 6.8% 1993 to 4.2% in 1997, lethality decreased from 6.9% to 5.4%, average length of stay before operation decreased from 2.6 to 2.1 days, the frequency of operations on weekends increased, complications in wound healing increased from 4.9 to 6.0%, cardiopulmonary complications decreased from 11.2% to 7.8%. Between 1993 to 1997 54.3% could be dismissed to their homes; the percentage of patients being sent to rehabilitation facilities after acute care rose from 8.3% in 1993 to 20.1% in 1997. Operative treatment was performed in more than 90% of all fractures in all counties of Westphalia-Lippe. However, there was a wide and significant geographical variation in the choice between osteosyntheses and hip replacement: the percentage of hip replacement differed between 57% and 82% among different counties.

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