Moraleda L, Castellote M
Unidad de Traumatología y Ortopedia Infantil, Hospital Universitario La Paz, Madrid, España.
Centro de Especialidades de Peñagrande, Madrid, España.
An Pediatr (Barc). 2015 Aug;83(2):89-93. doi: 10.1016/j.anpedi.2014.10.023. Epub 2014 Dec 23.
The aim of this study was to identify the commonest referrals to a paediatric orthopaedic outpatient clinic and, therefore, to be able to improve the paediatric residency program in managing musculoskeletal problems.
Demographic data, referrals and final diagnosis were collected prospectively on all patients that were evaluated in a paediatric orthopaedic outpatient clinic.
The majority of referrals were to evaluate musculoskeletal pain (37%), foot deformity (20%), spine deformity (15%), walking pattern (11%), alignment of the lower limbs (4%), and development of the hip (4%). A normal physical examination or a normal variation was observed in 42% of patients. A mild condition was observed in 17% of patients that should have only been referred to a paediatric orthopaedic clinic after failing to resolve pain with anti-inflammatories or physiotherapy. A mild deformity that only needed treatment if it became symptomatic was seen in 8% of patients.
The majority of referrals were due to a normal variation or mild conditions that only required symptomatic treatment. Paediatric residency programs do not reflect the prevalence of musculoskeletal conditions in clinical practice.
本研究的目的是确定小儿骨科门诊最常见的转诊原因，从而能够改进小儿住院医师培训计划在管理肌肉骨骼问题方面的能力。
前瞻性收集在小儿骨科门诊接受评估的所有患者的人口统计学数据、转诊原因和最终诊断结果。
大多数转诊是为了评估肌肉骨骼疼痛（37%）、足部畸形（20%）、脊柱畸形（15%）、行走模式（11%）、下肢对线（4%）和髋关节发育情况（4%）。42%的患者体格检查正常或存在正常变异。17%的患者病情较轻，这些患者本应在使用抗炎药或物理治疗未能缓解疼痛后才转诊至小儿骨科门诊。8%的患者存在轻度畸形，只有在出现症状时才需要治疗。
大多数转诊是由于正常变异或仅需对症治疗的轻度病症。小儿住院医师培训计划未反映临床实践中肌肉骨骼疾病的患病率。
