The clinical evidence behind the current implants used for proximal femoral fractures is weak considering the number of implants used worldwide .
Sporadic evaluation is not sufficient to identify long term problems .
INTRODUCTION Evaluation of the long-term performance of  implants used in trauma surgery relies on post-marked clinical studies since no registry based implant assessment exists .
The purpose of this study was to evaluate the evidence of performance of implants  currently used for treating proximal femoral fractures ( PFF ) in Denmark .
Implementing, Adapting, and Validating an Evidence-Based Algorithm for Hip Fracture Surgery
Objectives : Reoperations are common after surgical treatment of hip fractures but may be reduced by optimal choice of implant based on fracture classification . We hypothesized that implementing a surgical treatment algorithm was possible in our hospital and would result in a reduced reoperation rate . Design : Retrospective comparative study . Setting : Provincial level III trauma center . Patients : The evidence -based “ Hvidovre Algorithm ” for treatment of hip fractures was adopted and implemented at our provincial institution in September 2008 . Three hundred eighty-six consecutive patients older than 50 years admitted with a hip fracture in the first year after implementation were prospect ively included and compared with 417 retrospectively included similar patients admitted within the last year before implementation . Intervention : Implementation of an evidence -based treatment algorithm for hip fracture surgery . Results : Eighty-five percent ( 330 of 386 ) patients were operated according to the algorithm after implementation , compared with 67 % ( 280 of 417 ) of procedures before implementation ( P < 0.001 ) . After implementation , the overall reoperation rate showed a tendency toward a reduction to 8 % ( 32 of 386 ) from 12 % ( 48 of 417 ) ( P = 0.1 ) . Among all the 803 included patients , the reoperation rate was lower if procedures had been performed according to the algorithm recommendations : 9 % ( 53 of 610 ) versus 14 % ( 27 of 193 ) ( P = 0.009 ) . Conclusions : The algorithm for hip fracture surgery was easily implemented , and our results support that using it facilitates a low reoperation rate . The reoperation rate may be further reduced with higher adherence to algorithm recommendation . Level of Evidence : Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence
The clinical evidence behind the current implants used for proximal femoral fractures is weak considering the number of implants used worldwide .
Sporadic evaluation is not sufficient to identify long term problems .
INTRODUCTION Evaluation of the long-term performance of  implants used in trauma surgery relies on post-marked clinical studies since no registry based implant assessment exists .
The purpose of this study was to evaluate the evidence of performance of implants  currently used for treating proximal femoral fractures ( PFF ) in Denmark .