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Let Orthopedic Surgery Wait Until Morning When Possible
Date:9/7/2009

More minor complications seen with 'after-hours' procedures, study finds

MONDAY, Sept. 7 (HealthDay News) Scheduling a prime daytime slot to undergo an orthopedic procedure may lower your risk of an unplanned follow-up surgery later on, a new study has found.

The study, published in the September issue of The Journal of Bone and Joint Surgery, found little difference otherwise for healing, recovery time and major complication rates between certain orthopedic surgeries done during the day (between 6 a.m. and 4 p.m.) and those done after hours (4 p.m. to 6 a.m.).

"Although everyone wants to be treated immediately, it may be in a patient's best interest to wait until morning. The reality is that the on-call night surgical team may not be well rested, as it is likely they had just finished a normal day shift," study lead author Dr. William M. Ricci, chief of the Orthopaedic Trauma Service at the Washington University School of Medicine in St. Louis, said in a news release issued by the American Academy of Orthopaedic Surgeons.

The study of 203 surgeries to repair either a fractured thigh or shin bone found a higher incidence of follow-up surgery to remove painful hardware (often a supportive rod called an intramedullary nail fixation that was placed to stabilize the broken bone) in the after-hours patients than the daytime patients -- 27 percent versus 3 percent, respectively.

"The results of the study suggest that the system is working fairly well and it is not always best to rush a patient to the OR in the middle of the night. Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day," Ricci said in the news release.

"For non-emergent fracture care, sufficient daytime resources should be made available to avoid unnecessary night-time surgery," he added.

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