دورية أكاديمية
أعرض في EDS

Buckling down on torus fractures: has evolving evidence affected practice?

التفاصيل البيبلوغرافية
العنوان: Buckling down on torus fractures: has evolving evidence affected practice?
المؤلفون: Williams BA; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA., Alvarado CA; University of Florida - College of Medicine, Gainesville, Florida, USA., Montoya-Williams DC; Department of Paediatrics, University of Florida, Gainesville, Florida, USA., Matthias RC; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA., Blakemore LC; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.
المصدر: Journal of children's orthopaedics [J Child Orthop] 2018 Apr 01; Vol. 12 (2), pp. 123-128.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: SAGE Publications Country of Publication: England NLM ID: 101313582 Publication Model: Print Cited Medium: Print ISSN: 1863-2521 (Print) Linking ISSN: 18632521 NLM ISO Abbreviation: J Child Orthop Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: 2022- : [London] : SAGE Publications
Original Publication: Heidelberg : Springer, 2007-
مستخلص: Purpose: The purpose of this study was to evaluate the management of paediatric torus fractures of the distal forearm in current practice in light of growing evidence supporting a 'minimalist' approach with splint immobilization and limited follow-up. We hypothesized that 'traditional' cast-based management has persisted despite alternative evidence.
Methods: A retrospective review was performed of a consecutive series of paediatric patients diagnosed with torus fractures of the distal forearm between 2011 and 2014. Records were reviewed to abstract the type of immobilization (splint versus cast) prescribed at each visit, number of radiographic exams, duration of immobilization, number of clinical visits and complications. The primary outcome was the proportion of patients exclusively managed in splints. Injuries were grouped based on treatment into a cast group (CG) and a splint group (SG) for statistical analyses. Additionally, injuries were grouped by epoch of time to determine if immobilization usage patterns evolved.
Results: A total of 240 forty injuries met criteria for inclusion. Of these, 16 (6.7%) were exclusively splinted (SG). Relative to the CG, the SG had fewer clinical visits (p < 0.001), fewer radiographic exams (p < 0.001) and a shorter total encounter time (p = 0.015). No change in immobilization use occurred over the study period. In all, 21 (9.4%) of the CG experienced complications. No clinically significant displacements occurred in either group.
Conclusion: Cast utilization and frequent radiographic follow-up remain prevalent at our institution in the management of paediatric torus fractures. Splint-only management was associated with fewer clinical visits, fewer radiographic exams and a shorter total encounter time.
Level of Evidence Level Iii: Therapeutic retrospective cohort study.
References: J Bone Joint Surg Br. 2001 Nov;83(8):1173-5. (PMID: 11764434)
J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686)
Pediatr Emerg Care. 2008 Feb;24(2):65-70. (PMID: 18277840)
J Pediatr Orthop. 2015 Jan;35(1):18-23. (PMID: 24887079)
Acta Orthop Belg. 2007 Oct;73(5):594-7. (PMID: 18019914)
Trauma Mon. 2013 Winter;17(4):370-2. (PMID: 24350129)
J Bone Joint Surg Br. 2001 May;83(4):556-60. (PMID: 11380131)
Injury. 2013 Apr;44(4):508-13. (PMID: 23265786)
Pediatrics. 2006 Mar;117(3):691-7. (PMID: 16510648)
J Pediatr Orthop. 2005 May-Jun;25(3):322-5. (PMID: 15832147)
Emerg Nurse. 2014 Feb;21(9):22-6. (PMID: 24494768)
Pediatr Emerg Care. 2014 Jul;30(7):462-8. (PMID: 24977995)
J Pediatr Orthop B. 2016 Mar;25(2):183-90. (PMID: 26523533)
J Am Acad Orthop Surg. 1998 May-Jun;6(3):146-56. (PMID: 9689186)
J Pediatr Orthop. 2005 Jul-Aug;25(4):495-500. (PMID: 15958903)
Pediatr Emerg Care. 2013 May;29(5):555-9. (PMID: 23603644)
Int Emerg Nurs. 2009 Jul;17 (3):173-8. (PMID: 19577205)
Arch Pediatr Adolesc Med. 1999 Sep;153(9):923-5. (PMID: 10482206)
CMAJ. 2010 Oct 5;182(14):1507-12. (PMID: 20823169)
معلومات مُعتمدة: UL1 TR001427 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: Buckle fracture; closed management; evidence-based medicine; wrist fracture
تواريخ الأحداث: Date Created: 20180501 Latest Revision: 20220317
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC5902745
DOI: 10.1302/1863-2548.12.170122
PMID: 29707050
قاعدة البيانات: MEDLINE
الوصف
تدمد:1863-2521
DOI:10.1302/1863-2548.12.170122