Cephalomedullary Nailing of Extracapsular Hip Fractures Before and During the COVID-19 Pandemic: A Rural UK Cohort Study.
Year: 2026
Type: article
Abstract: Introduction: The COVID-19 pandemic substantially disrupted orthopedic services, but its effect on fracture patterns and fixation strategies for extracapsular hip fractures remains unclear. This study evaluated whether the pandemic was associated with a change in cephalomedullary nail utilization in a rural UK population. Materials and Methods: A Level III retrospective cohort study was conducted at a rural UK district general hospital. Patients aged ≥50 years with extracapsular hip fractures treated with cephalomedullary nails were compared across two consecutive 24-month periods before (March 2018-March 2020) and during the pandemic (March 2020-March 2022). The primary outcome was the proportion of all hip fractures treated with cephalomedullary nails. Secondary outcomes included operative time, blood loss, reduction method, bisphosphonate use, complications, and 6- and 12-month mortality. Comparisons were unadjusted and used available data without imputation. Results: Among 658 hip fracture admissions, 95 underwent cephalomedullary fixation. Nailing accounted for 13.3% of fractures before and 15.8% during the pandemic (P = 0.36). Operative time increased significantly from 90 to 140 min (P < 0.001). Differences in open reduction, blood loss, bisphosphonate use, complications, and 6 and 12-month mortality were not statistically significant. Conclusion: The COVID-19 pandemic was not associated with a significant change in cephalomedullary nail utilization. However, operative times increased substantially, suggesting persistent effects on surgical efficiency. Given the retrospective, single-center design, modest sample size and incomplete secondary data, these findings are hypothesis-generating, and multicenter studies incorporating fracture classification and risk-adjusted outcomes are warranted.
Source: PubMed
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225559556
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