Immediate Spica Casting of Pediatric Femoral Fractures in the Operating Room Versus the Emergency Department
| Autor: | Jill C. Wilmoth, Ashton S. Mansour, Alfred A. Mansour, Jeffrey E. Martus, Gregory A. Mencio, Steven A. Lovejoy |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Operating Rooms medicine.medical_specialty Time Factors Sedation medicine Humans Orthopedics and Sports Medicine Retrospective Studies Femur fracture business.industry Standard treatment Infant Retrospective cohort study General Medicine Emergency department Hip spica cast Hospital Charges Surgery Casts Surgical Child Preschool Pediatrics Perinatology and Child Health Orthopedic surgery Cohort Female medicine.symptom Emergency Service Hospital business Femoral Fractures |
| Zdroj: | Journal of Pediatric Orthopaedics. 30:813-817 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0b013e3181fcb613 |
| Popis: | BACKGROUND Immediate spica casting for pediatric femur fractures is well described as a standard treatment in the literature. The purpose of this study is to evaluate the application of a spica cast in the emergency department (ED) versus the operating room (OR) with regard to quality of reduction, complications, and hospital charges at an academic institution. METHODS An institutional review board-approved retrospective review identified 100 children aged 6 months to 5 years between January 2003 and October 2008 with an isolated femur fracture treated with a hip spica cast. Patients were compared based on the setting of spica cast application. RESULTS There were 79 patients in the ED cohort and 21 patients in the OR cohort. There were no significant differences in age, weight, sex, fracture pattern, prereduction shortening, injury mechanism, duration of spica treatment, time to heal, or length of follow-up between cohorts. There were no significant differences in the rate of loss of reduction requiring revision casting or operative treatment (6.3% vs. 4.8%), the need for cast wedging (8.9% vs. 14.3%), or minor skin breakdown (12.7% vs. 14.3%). There were no sedation or anesthetic complications in either group. There were no significant differences in the quality of reduction or the rate of complications between the 2 groups. Spica casting in the OR delayed the time from presentation to cast placement as compared with the ED cohort (11.5 h vs. 3.8 h, P |
| Databáze: | OpenAIRE |
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