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    An inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures.

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    Authors
    Donnelly, M
    Green, C
    Kelly, I P
    Affiliation
    Department of Orthopaedic Surgery, Waterford Regional Hospital, Dunmore road, Waterford, Ireland.
    Issue Date
    2012-06
    MeSH
    Analysis of Variance
    Bone Nails
    Bone Wires
    Chi-Square Distribution
    Child
    Child, Preschool
    Cohort Studies
    Dislocations
    Elbow Joint
    Emergency Treatment
    Female
    Fracture Fixation
    Fracture Fixation, Internal
    Humans
    Humeral Fractures
    Injury Severity Score
    Length of Stay
    Male
    Pain Measurement
    Prognosis
    Range of Motion, Articular
    Recovery of Function
    Registries
    Retrospective Studies
    Risk Assessment
    Time Factors
    Treatment Outcome
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    Citation
    An inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures. 2012, 10 (3):143-7 Surgeon
    Journal
    The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
    URI
    http://hdl.handle.net/10147/245433
    DOI
    10.1016/j.surge.2011.03.002
    PubMed ID
    22525415
    Abstract
    The need for emergent management of displaced paediatric supracondylar humeral fractures is being questioned in the literature. Open reduction rates of up to 46% have been reported in the non-emergent management of these injuries. At our institution these fractures are managed as operative emergencies by senior personnel. To examine the ongoing need for this policy we reviewed our results. All patients managed over a five year period with Gartland type IIB or III paeditric supracondylar humeral fractures were identified and a comprehensive chart and radiographic review undertaken. The mean time from injury to fracture reduction and stabilization was 6.6 h. Consultants performed or supervised 90% of cases. Open reduction was necessary in 5% of cases. Complications included a perioperative nerve injury rate of 6% and a superficial pin site infection rate of 3%. This study suggests that, despite the challenge to trauma on-call rostering, the emergency management of these injuries is advantageous to patients in units of our size. Based on the data presented here we continue our practice of emergent management. We suggest that units of a similar size to our own would show a benefit from an analogous policy albeit an inconvenient truth.
    Item Type
    Article
    Language
    en
    ISSN
    1479-666X
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.surge.2011.03.002
    Scopus Count
    Collections
    University Hospital Waterford

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