دورية أكاديمية
Risk Factors for Upper Extremity Refractures in Children.
| العنوان: | Risk Factors for Upper Extremity Refractures in Children. |
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| المؤلفون: | Gottschalk HP; Central Texas Pediatric Orthopedics, Dell Children's Medical Center of Central Texas.; Department of Surgery and Perioperative Care., Hughes Garza H; Dell Children's Medical Center of Central Texas, Trauma and Injury Research Center, Austin, TX., Barczyk AN; Department of Population Health, Dell Medical School, University of Texas at Austin.; Dell Children's Medical Center of Central Texas, Trauma and Injury Research Center, Austin, TX., Duzinski SV; Dell Children's Medical Center of Central Texas, Trauma and Injury Research Center, Austin, TX., Lawson KA; Department of Surgery and Perioperative Care.; Dell Children's Medical Center of Central Texas, Trauma and Injury Research Center, Austin, TX. |
| المصدر: | Journal of pediatric orthopedics [J Pediatr Orthop] 2022 Sep 01; Vol. 42 (8), pp. 413-420. Date of Electronic Publication: 2022 Jul 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins Original Publication: New York Ny : Raven Press |
| مواضيع طبية MeSH: | Forearm Injuries*/epidemiology , Fractures, Bone*/epidemiology, Humans ; Recurrence ; Retrospective Studies ; Risk Factors ; Upper Extremity |
| مستخلص: | Background: Multiple descriptive studies have been published on refracture patterns, particularly for forearm fractures. However, few large cohorts have been analyzed quantitatively including the odds of refracture, and with a comprehensive assessment of the possible predictive factors associated with refracture. This study aimed to assess the frequency and timing of upper extremity refracture in a large pediatric orthopaedics practice, and to evaluate the strength of association of various patient-level and fracture-related factors with refracture. Methods: Medical records were reviewed retrospectively for patients 1 to 18 years of age with at least 1 upper extremity fracture (ICD-9 codes 810 to 819) between June 1, 2010 and May 31, 2011. Characteristics of patients and fractures were assessed for the association with refracture using bivariate analysis and multivariable logistic regression. Results: Among 2793 patients with a total of 2902 upper extremity fractures, 2% were treated for refracture within 2 years, at a median of 6 months (188 d) after the initial injury. Midshaft location, and characterization of the fracture as angulated or buckle, were associated with being more likely to refracture. Eighty percent of refractures were the result of a fall, with almost 25% involving a high-energy mechanism and about 15% from monkey bars or other playground equipment. The adjusted odds of refracture were 4 times higher if noncompliance with treatment recommendations was documented, when controlling for insurance type and number of days before orthopaedic evaluation. Forearm fractures were almost 4 times more likely to refracture compared with other bones, controlling for midshaft location, days immobilized, and buckle or torus characterization of the fracture. Conclusions: Our practice saw a refracture occurrence in 2% of patients, with median time to refracture of ~6 months. The factors most strongly associated with refracture were midshaft fracture location, forearm fracture as opposed to clavicle or humerus, and noncompliance as defined in the study. Falls and high energy activities, such as use of wheeled devices, skis, or trampolines, were important mechanisms of refracture. Level of Evidence: This study is a Level II prognostic study. It is a retrospective study that evaluates the effect of patient and fracture characteristics on the outcome of upper extremity refracture. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.) |
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| تواريخ الأحداث: | Date Created: 20220714 Date Completed: 20220810 Latest Revision: 20220810 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/BPO.0000000000002211 |
| PMID: | 35834375 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1539-2570 |
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| DOI: | 10.1097/BPO.0000000000002211 |