Early results and future challenges of the Danish Fracture Database

INTRODUCTION: The Danish Fracture Database (DFDB) was established in 2011 to establish nationwide prospective quality assessment of all fracture-related surgery. In this paper, we describe the DFDB's setup, present preliminary data from the first annual report and discuss its future potential. MATERIAL AND METHODS: The DFDB collaboration includes 13 hospitals and covers a population of 3.7 million. Data registration is performed online by the surgeon following surgery, and it includes patient-, trauma-and surgery-related data. Primary procedures, reoperations and planned secondary procedures are registered. Indication for reoperation is also recorded. The reoperation rate and the one-year mortality are the primary indicators of quality. RESULTS: Approximately 10,000 fracture-related surgical procedures were registered in the database at the time of presentation of the first annual DFDB report (currently 15,000). 85% of all procedures were performed on adult fractures and 15% on paediatric fractures. Proximal femur (33%), distal radius (15%) and malleolar fractures (12%) were the three most common primary adult fractures. Pain and discomfort from orthopaedic hardware, infection and failure of osteosynthesis were the three most common indications for reoperation and accounted for 34%, 14% and 13%, respectively. CONCLUSION: The DFDB is an online database for registration of fracture-related surgery that allows for basic quality assessment of surgical fracture treatment and large-scale observational research by registering primary surgery, reoperations and planned secondary procedures.