Extended Bayram Holidays and Surgical Timing in Orthopaedic Fracture Patients: A Matched-Control Study, 2016–2025

Aims: To assess whether admission during Ramadan Bayram or Eid al-Adha was associated with surgical timing in orthopaedic fracture patients. Hospital stay, surgery within 48 hours, and one-year reoperation were secondary outcomes.Methods: This single-centre retrospective matched-period cohort study included patients admitted between June 2016 and June 2025. Twenty Bayram holiday periods were matched with control periods of identical duration from the preceding two weeks. Patients requiring immediate surgery, those with open injuries, and those admitted directly to intensive care were excluded. Mixed-effects models adjusted for age, sex, ASA grade, femoral fracture status, and multiple fractures.Results: The cohort included 192 patients: 100 admitted during holiday periods and 92 during control periods. Median time to surgery was 4.5 days during holidays and 4.0 days during control periods (p=0.169). After adjustment, holiday admission was not associated with time to surgery (adjusted geometric mean ratio 1.03, 95% confidence interval 0.85–1.24; p=0.781). Surgery within 48 hours was similar between groups (36.0% vs 31.5%; p=0.512). Hospital stay was longer during holidays in the unadjusted analysis (median 9 vs 7 days; p=0.004), but not after adjustment (p=0.702). Older age was associated with longer time to surgery and hospital stay, while multiple fractures were associated with longer hospital stay. One-year reoperation rates were similar (6.0% vs 4.3%; p=0.750).Conclusion: Bayram holiday admission was not independently associated with delayed surgery, prolonged hospital stay, or one-year reoperation.Keywords: Fractures, Bone; Time-to-Treatment; Length of Stay; Reoperation; Holidays