Intrainstitutional Changes of the Treatment of Supracondylar Humerus Fracture in Children over a Period of 9 Years

被引:0
|
作者
Wagner, Ferdinand [1 ,2 ,3 ]
Boeriu, Amalia [1 ]
Eberz, Pascal [1 ]
Weigert, Annabelle [1 ]
Holzapfel, Boris Michael [1 ]
Boecker, Wolfgang [1 ]
Hubertus, Jochen [3 ]
Muensterer, Oliver [3 ]
Bergmann, Florian [3 ]
Ziegler, Christian Max [1 ]
机构
[1] Ludwig Maximilians Univ Munchen, Musculoskeletal Univ Ctr Munich MUM, LMU Univ Hosp, Dept Orthopaed & Trauma Surg, Marchioninistr 15, D-81377 Munich, Germany
[2] Queensland Univ Technol QUT, Inst Hlth & Biomed Innovat, Brisbane, Qld 4059, Australia
[3] Ludwig Maximilians Univ Munchen, Dr Hauner Childrens Hosp, Dept Pediat Surg, Lindwurmstr 4, D-80337 Munich, Germany
来源
CHILDREN-BASEL | 2024年 / 11卷 / 01期
关键词
elbow fractures; fracture fixation; intramedullary; hospitals; university; learning curve; operative time; quality of life; retrospective studies; QUALITY-OF-LIFE; ULNAR NERVE INJURY; PERIOPERATIVE COMPLICATIONS; SURGICAL DELAY; ADOLESCENTS; MANAGEMENT;
D O I
10.3390/children11010027
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
To assess changes in treatment modalities for supracondylar humerus fractures (SCHFs) at a large pediatric university hospital, we analyzed patient data from 2014 to 2022. A total of 233 SCHFs treated surgically at our hospital were included. To evaluate postoperative outcome and quality of life, DASH and EuroQol-5D-Y questionnaires were sent to patients. In addition to a significant fluctuation in fracture severity, we found an increase in training interventions (more surgeries were performed by trainees) and a significant decrease in surgery times after 2016. From 2020, there was a significant shift in the type of surgical method away from closed reduction with elastic stable intramedullary nailing (ESIN) and towards closed reduction and crossed K-wire osteosynthesis (CRK). Surgeries performed in the morning and evening hours increased, while those performed in the afternoon and after midnight decreased. After a mean follow-up of 4 years, there was no difference in elbow function between ESIN and open reduction and K-wires (ORK). Treatment with ESIN was equivalent to ORK in terms of function, at least in the medium-term follow-up. In summary, the combination of shifting treatment from SCHF to daytime hours, increasing trainee participation and using cross K-wire fixation instead of ESIN had no negative impact on surgery times. In our setting, these measures have reduced resource utilization and increased efficiency without compromising patient care.
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页数:14
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