Alexander David, Horstmann Joanna J, Walker Janet, Talwalkar Vishwas, Iwinski Henry, Milbrandt Todd A
Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
Iowa Orthop J. 2014;34:166-70.
Pediatric femur fractures are common injuries presenting to tertiary care trauma centers. Transportation of these patients occurs most commonly via ambulance or flight. The purpose of this study is to evaluate whether mode of transportation affects time to surgery or hospital stay for pediatric patients with femur fractures.
Utilizing a trauma registry we queried pediatric femur fractures between January 2001 and December 2009. Patient age, gender, mechanism of injury, month of injury, type of fracture, transportation, county of origin, time to operating room (TTOR), hospital length of stay (HLOS), and treatment received were identified and compared.
In total, 519 femur fractures were identified, 257 (49.5%) of which were isolated injuries. Flight transportation was utilized in 13.6 % (35 of 257) of these isolated fractures. Mean TTOR for flight patients was 29 hours, HLOS 3.2 days. For ambulance transportation mean TTOR was 41 hours, HLOS 3.2 days. Neither variable was statistically different between transportation groups (TTOR p > 0.50; HLOS p > 0.95). No statistical difference was seen in HLOS (p > 0.47) and TTOR (p > 0.71) for patients originating further distances from the hospital.
Transportation method and distance from the hospital did not affect the TTOR and HLOS for isolated pediatric femur fractures. The use of air transportation for this group of patients, many of whom are injured by relatively low energy mechanisms, may be excessively costly and does not accelerate treatment.
小儿股骨骨折是三级创伤中心常见的损伤。这些患者最常通过救护车或空中转运。本研究的目的是评估转运方式是否会影响小儿股骨骨折患者的手术时间或住院时间。
利用创伤登记系统，我们查询了2001年1月至2009年12月期间的小儿股骨骨折病例。确定并比较了患者的年龄、性别、损伤机制、损伤月份、骨折类型、转运方式、原籍县、手术室时间（TTOR）、住院时间（HLOS）以及接受的治疗。
共确定519例股骨骨折，其中257例（49.5%）为单纯损伤。这些单纯骨折中有13.6%（257例中的35例）采用空中转运。空中转运患者的平均TTOR为29小时，HLOS为3.2天。救护车转运的平均TTOR为41小时，HLOS为3.2天。两组之间这两个变量均无统计学差异（TTOR p>0.50；HLOS p>0.95）。距离医院较远的患者在HLOS（p>0.47）和TTOR（p>0.71）方面无统计学差异。
转运方式和距离医院远近并未影响单纯小儿股骨骨折的TTOR和HLOS。对于这组患者，其中许多是因相对低能量机制受伤，使用空中转运可能成本过高且不会加速治疗。
