Change in treatment preferences in pediatric diaphyseal forearm fractures: a Danish nationwide register study of 36,244 fractures between 1997 and 2016.

Autor: Hansen RT; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark., Borghegn NW; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark., Gundtoft PH; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark; Department of Orthopaedic Surgery and Traumatology, Aarhus University Hospital., Nielsen KA; Department of Orthopaedic Surgery and Traumatology, Zealand University Hospital., Balslev-Clausen A; Department of Orthopaedic Surgery and Traumatology, Hvidovre Hospital., Viberg B; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark. bjarke.viberg@rsyd.dk.
Jazyk: angličtina
Zdroj: Acta orthopaedica [Acta Orthop] 2023 Feb 01; Vol. 94, pp. 32-37. Date of Electronic Publication: 2023 Feb 01.
DOI: 10.2340/17453674.2023.7132
Abstrakt: Background and Purpose: The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period.  Patients and methods: This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramedullary nailing [IMN], and open reduction internal fixation [ORIF]). The secondary outcomes were further sub-analyses on invasive treatment and age groups.
Results: 36,244 diaphyseal forearm fractures were investigated, yielding a mean incidence of 172 per 105/year. The proportion of fractures treated invasively increased from 1997 to 2016, from 4% to 23%. The use of Kirschner wires increased from 1% to 9%, IMN increased from 1% to 14%, and ORIF decreased from 2% to 1%. The changes were evident in all age groups but smaller in the 0-3-year age group.
Conclusion: We found an increase in invasive treatment of pediatric diaphyseal forearm fractures over the investigated period. A change in invasive methods was also found, as the rate of IMN increased over the investigated period and became the predominant surgical treatment choice.
Databáze: MEDLINE
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