Andrew Nordin1, Junxin Shi2,3, Brian Kenney1, Henry Xiang2,3,4, Julie Balch Samora1,5. 1. Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA. 2. Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 3. Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 4. The Ohio State University College of Medicine, Columbus, OH, USA. 5. Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Abstract
OBJECTIVE: Supracondylar humerus (SCH) fractures represent one of the most commonly treated fractures. We sought to determine: 1) how often SCH fractures are associated with vascular injury; 2) mechanism of injuries; 3) where cases are treated 4) time to operating room (OR); and 5) length of stay (LOS). METHODS: The 2007-2014 National Trauma Data Bank (NTDB) data were analyzed for all patients <18 years of age who presented with an isolated supracondylar humerus fracture, with or without an associated vascular injury. Both non-operative and operative management were included. Main outcome measures were demographics, mechanism of injury, presence of vascular injury, time to OR, number of OR procedures, type of treating facility, and LOS. Comparisons were performed using Chi square test for categorical variables and Student's t-test for continuous variables. RESULTS: We identified a total of 53,571 pediatric patients over eight years with SCH fractures. Vascular injuries occurred in 149 patients (0.3%), which were significantly more common with open fractures (p < 0.001). Patients with vascular injuries had significantly longer LOS (3.5 days v 1.4 days; p < 0.001) and shorter times to the OR (4.7 h v 10.4 h; p < 0.001), and were more likely to be treated in teaching hospitals and pediatric level 1 trauma centers (p = 0.037). CONCLUSION: The percentage of vascular injuries associated with SCH fractures in pediatric patients remains low (0.3%). The majority of pediatric patients with these injuries are treated at level 1 pediatric trauma centers. LEVEL OF EVIDENCE: Therapeutic, III.
OBJECTIVE: Supracondylar humerus (SCH) fractures represent one of the most commonly treated fractures. We sought to determine: 1) how often SCH fractures are associated with vascular injury; 2) mechanism of injuries; 3) where cases are treated 4) time to operating room (OR); and 5) length of stay (LOS). METHODS: The 2007-2014 National Trauma Data Bank (NTDB) data were analyzed for all patients <18 years of age who presented with an isolated supracondylar humerus fracture, with or without an associated vascular injury. Both non-operative and operative management were included. Main outcome measures were demographics, mechanism of injury, presence of vascular injury, time to OR, number of OR procedures, type of treating facility, and LOS. Comparisons were performed using Chi square test for categorical variables and Student's t-test for continuous variables. RESULTS: We identified a total of 53,571 pediatric patients over eight years with SCH fractures. Vascular injuries occurred in 149 patients (0.3%), which were significantly more common with open fractures (p < 0.001). Patients with vascular injuries had significantly longer LOS (3.5 days v 1.4 days; p < 0.001) and shorter times to the OR (4.7 h v 10.4 h; p < 0.001), and were more likely to be treated in teaching hospitals and pediatric level 1 trauma centers (p = 0.037). CONCLUSION: The percentage of vascular injuries associated with SCH fractures in pediatric patients remains low (0.3%). The majority of pediatric patients with these injuries are treated at level 1 pediatric trauma centers. LEVEL OF EVIDENCE: Therapeutic, III.
Authors: Robert Moverley; Kenneth S Rankin; Iain McNamara; Donald James Davidson; Mike Reed; Andrew P Sprowson Journal: Int Orthop Date: 2013-01-19 Impact factor: 3.075
Authors: S Sabharwal; S J Tredwell; R D Beauchamp; W G Mackenzie; D M Jakubec; R Cairns; J G LeBlanc Journal: J Pediatr Orthop Date: 1997 May-Jun Impact factor: 2.324