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Dedicated hip fracture service: implementing a novel model of care


  • B. S. Sivakumar BSci (Med), MBBS, MS; L. M. McDermott MBBS (Hons), FRACS (Orth); J. J. Bell BBMedSci, APD; C. R. Pulle MBBS, FRACP; S. Jayamaha MBBS, FRCA; M. C. Ottley MBChB (Hons), FRACS (Orth).


Dr Brahman Shankar Sivakumar, Department of Orthopaedics, The Prince Charles Hospital, 42 Kingfisher Cresent, Belmont Heights, Brisbane, QLD 4153, Australia. Email:



Hip fracture is a common clinical problem with historically high morbidity and mortality, and various model of acute and subacute care have been employed. We describe 12-month results from the first dedicated hip fracture unit in Australia, and compare it with other models of care both locally and internationally.


This was performed as a prospective uncontrolled study over a 12-month period. After application of exclusion criteria, a total of 346 patients were yielded. Outcomes measured included performance indicators as well as morbidity and mortality data.


Improvements in performance indicators (adequate preoperative medical assessment, time to surgery, return to premorbid residence, etc.) and morbidity and mortality data (such as pressure sores, infections and in-hospital death) are noted.


Early results suggest more comprehensive preoperative assessment, shorter times to theatre, reduced post-operative complications and diminished mortality rates when the principles undermining this unit are instituted.