Guidelines or State Civil Codes in the Management of Femoral Neck Fracture? An Analysis of the Reality of Care Provision in North Rhine-Westphalia: In Reply

by Prof. Dr. med. Rüdiger Smektala, Dr. med. Angelika Grams, Prof. Dr. med. Ludger Pientka, Dr. med. Dr. PH. Ulrich Schulze Raestrup in volume 16/2008

Thus far, assessment of the quality of care for femoral neck fractures is only possible in inpatients.

Questions concerning the long term survival or, as Lukoschek raises, the quality of endoprosthetic care provision can be answered only by means of cross-sectoral health services research. In Germany, we are merely in the very early stages of conducting such studies. Data protection issues have thus far made cross-sectoral research almost impossible.

I welcome Lukoschek's comments, which show that there is a requirement for long term observations to be made possible in Germany.

In the course of our observations with regard to the quality of care for femoral neck fractures we found that the use of monopolar prostheses in Westphalia-Lippe has undergone a constant decline, whereas the use of dual-head prostheses increased. Lukoschek's critical remarks about this type of prosthesis underline the fact that further studies are needed.
DOI: 10.3238/arztebl.2008.0540b

Prof. Dr. med. Rüdiger Smektala
Chirurgische Universitätsklinik
Knappschaftskrankenhaus Bochum-Langendreer
In der Schonau 23–25
44892 Bochum, Germany
[e-mail]

Conflict of interest statement
The authors of the letter and the reply declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.