ObjectiveThe aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections.DesignA retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data.SettingUK University Teaching HospitalParticipantsAll patients (n = 460) presenting across a single year study period with a confirmed hip fracture.Outcome measuresThe presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified.ResultsA total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection (p-value: 0.0005).ConclusionThe results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection.

No abstract

Background Late presentation of Quadriceps tendon rupture (QTR) is rare. Treatment of neglected QTR's can be challenging due to scar tissue and muscle wasting and may require augmentation. Delayed tendon repairs tend to have less favourable outcome compared to acute repairs. There are very few case reports of delayed repair using various techniques. Methods a case series of 5 patients (6 tendon ruptures) presenting late with quadriceps tendon rupture. Repair was performed using a Codivilla V—Y plasty to extend the tendon, followed by LARS artificial ligament augmentation. All patients then received 6 weeks targeted physiotherapy after wound healing. Results Repair using our technique was possible in all patients. No patients needed to return to theatre due to re-rupture or infection. Only one patient required oral antibiotics for a superficial wound infection. No patient was left with a functional deficit following physiotherapy, with 4 of the 6 repairs achieving a full range of movement. Conclusions V—Y plasty followed by LARS augmentation can be used safely and reproducibly for the repair of delayed presentation quadriceps tendon ruptures in our cohort comprising of both healthy and co-morbid patients to achieve good functional results.

No abstract