Presentation to the Emergency Department Increases the Likelihood of Surgical Management of Minimally Displaced Gartland Type IIa Pediatric Supracondylar Humerus Fractures.
Jonathan D Groothoff, Nicholas R Kiritsis, Garrett S Bullock, John Frino, Michael S Hughes, James F Mooney, Alejandro Marquez-Lara
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引用次数: 0
Abstract
Background: Few studies have explored factors influencing the clinical decision-making process in the management of Gartland type IIa supracondylar humerus fractures (SCHFs). This study sought to determine whether the location of patient presentation and patient socioeconomic status are associated with the treatment of type IIa SCHFs.
Methods: This was a retrospective review of 262 patients younger than 13 years of age seen for acute Gartland type II SCHFs between 2012 and 2022. Pre-treatment radiographs were reviewed to measure Baumann angle and the location of the anterior humeral line relative to the capitellum. Demographic characteristics and socioeconomic status, measured through Child Opportunity Index (COI) scores, were generated and logistic regression analysis was performed to evaluate the relationship between location of presentation and fracture management. Logistic regressions were also used to evaluate the relationship between COI and location of presentation and treatment.
Results: 137 male and 125 female patients met the inclusion criteria with a mean age of 5.95 (0.13) years at the time of presentation. Presentation to the emergency department (ED) demonstrated reduced odds of closed reduction and casting compared to outpatient clinic presentation [0.13 (95% CI: 0.02-0.98), P=0.048]. 27.5% of minimally displaced fractures that presented to the ED and 20.0% of minimally displaced fractures that presented to an outpatient clinic were treated surgically. There was no association between COI and the location of patient presentation [1.2 (95% CI: 0.9-1.5), P=0.226] or treatment received [1.04 (95% CI: 0.48-2.26), P=0.922].
Conclusion: These results suggest that patients who present to the ED after type IIa SCHFs are more likely to receive surgical treatment. COI does not appear to be associated with the location of presentation or treatment received.
期刊介绍：
Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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