Heather A Prentice1, Elizabeth W Paxton2, Jessica J Hunt3, Christopher D Grimsrud4, Jennifer M Weiss5. 1. Research Scientist I Investigator in Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego. heather.prentice@kp.org. 2. Director of Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego. liz.w.paxton@kp.org. 3. Research Associate II in Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego. jessica.j.hunt@kp.org. 4. Orthopedic Surgeon at the Oakland Medical Center in CA. christopher.d.grimsrud@kp.org. 5. Orthopedic Surgeon at the Sunset Medical Center in Los Angeles, CA. jennifer.m.weiss@kp.org.
Abstract
CONTEXT: Hip fracture registries offer an opportunity to identify and to monitor patients with rare conditions and outcomes, including hip fractures in pediatric patients. OBJECTIVE: To report patient demographics and surgical outcomes of pediatric patients treated surgically for hip fractures in a large integrated health care system. DESIGN: Pediatric patients (< 21 years old at the time of fracture) with hip fractures were identified between 2009 and 2012 using our health care system's hip fracture registry. MAIN OUTCOME MEASURES: Patient characteristics, type of fracture, surgical treatment, and short-term complications. RESULTS: Among 39 patients identified, 31 (79.5%) were male, and the median age was 15 years old (interquartile range: 11-17 years). Most patients were Hispanic (n = 17, 43.6%) or white (n = 14, 35.9%). There were 8 patients (20.5%) with 15 comorbidities. Delbet Type IV (intertrochanteric) fractures were the most common fracture type (n = 22, 56.4%), and fixation method was equally distributed between intramedullary, screw and sideplate, and screws (n = 12, 30.8% for each). Most surgeries were performed by medium-volume surgeons (n = 22, 56.4%) at medium- and high-volume hospitals (n = 37, 94.9%). Three 90-day readmissions (7.7%), 1 infection (2.6%), 1 malunion (2.6%), and 1 revision (2.6%) were observed in this cohort during the study period. CONCLUSION: In our series using registry data, hip fractures younger than age 21 years were more common in boys and Hispanic patients. Intertrochanteric fractures (Delbet Type IV) were the most frequently observed type in our community-based hip fracture registry. Short-term complications were infrequent.
CONTEXT: Hip fracture registries offer an opportunity to identify and to monitor patients with rare conditions and outcomes, including hip fractures in pediatric patients. OBJECTIVE: To report patient demographics and surgical outcomes of pediatric patients treated surgically for hip fractures in a large integrated health care system. DESIGN: Pediatric patients (< 21 years old at the time of fracture) with hip fractures were identified between 2009 and 2012 using our health care system's hip fracture registry. MAIN OUTCOME MEASURES: Patient characteristics, type of fracture, surgical treatment, and short-term complications. RESULTS: Among 39 patients identified, 31 (79.5%) were male, and the median age was 15 years old (interquartile range: 11-17 years). Most patients were Hispanic (n = 17, 43.6%) or white (n = 14, 35.9%). There were 8 patients (20.5%) with 15 comorbidities. Delbet Type IV (intertrochanteric) fractures were the most common fracture type (n = 22, 56.4%), and fixation method was equally distributed between intramedullary, screw and sideplate, and screws (n = 12, 30.8% for each). Most surgeries were performed by medium-volume surgeons (n = 22, 56.4%) at medium- and high-volume hospitals (n = 37, 94.9%). Three 90-day readmissions (7.7%), 1 infection (2.6%), 1 malunion (2.6%), and 1 revision (2.6%) were observed in this cohort during the study period. CONCLUSION: In our series using registry data, hip fractures younger than age 21 years were more common in boys and Hispanic patients. Intertrochanteric fractures (Delbet Type IV) were the most frequently observed type in our community-based hip fracture registry. Short-term complications were infrequent.
Authors: Andrew J Karter; Assiamira Ferrara; Jennifer Y Liu; Howard H Moffet; Lynn M Ackerson; Joe V Selby Journal: JAMA Date: 2002-05-15 Impact factor: 56.272