Prentice Heather A, Paxton Elizabeth W, Hunt Jessica J, Grimsrud Christopher D, Weiss Jennifer M
Research Scientist I Investigator in Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego.
Director of Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego.
Perm J. 2017;21:16-081. doi: 10.7812/TPP/16-081.
Hip fracture registries offer an opportunity to identify and to monitor patients with rare conditions and outcomes, including hip fractures in pediatric patients.
To report patient demographics and surgical outcomes of pediatric patients treated surgically for hip fractures in a large integrated health care system.
Pediatric patients (< 21 years old at the time of fracture) with hip fractures were identified between 2009 and 2012 using our health care system's hip fracture registry.
Patient characteristics, type of fracture, surgical treatment, and short-term complications.
Among 39 patients identified, 31 (79.5%) were male, and the median age was 15 years old (interquartile range: 11-17 years). Most patients were Hispanic (n = 17, 43.6%) or white (n = 14, 35.9%). There were 8 patients (20.5%) with 15 comorbidities. Delbet Type IV (intertrochanteric) fractures were the most common fracture type (n = 22, 56.4%), and fixation method was equally distributed between intramedullary, screw and sideplate, and screws (n = 12, 30.8% for each). Most surgeries were performed by medium-volume surgeons (n = 22, 56.4%) at medium- and high-volume hospitals (n = 37, 94.9%). Three 90-day readmissions (7.7%), 1 infection (2.6%), 1 malunion (2.6%), and 1 revision (2.6%) were observed in this cohort during the study period.
In our series using registry data, hip fractures younger than age 21 years were more common in boys and Hispanic patients. Intertrochanteric fractures (Delbet Type IV) were the most frequently observed type in our community-based hip fracture registry. Short-term complications were infrequent.
髋部骨折登记系统为识别和监测患有罕见疾病及出现罕见结果的患者提供了契机，其中包括儿科患者的髋部骨折。
报告在一个大型综合医疗保健系统中接受手术治疗的儿科髋部骨折患者的人口统计学特征及手术结果。
2009年至2012年期间，利用我们医疗保健系统的髋部骨折登记系统识别出髋部骨折的儿科患者（骨折时年龄<21岁）。
患者特征、骨折类型、手术治疗及短期并发症。
在识别出的39例患者中，31例（79.5%）为男性，中位年龄为15岁（四分位间距：11 - 17岁）。大多数患者为西班牙裔（n = 17，43.6%）或白人（n = 14，35.9%）。有8例患者（20.5%）合并15种疾病。德尔贝IV型（转子间）骨折是最常见的骨折类型（n = 22，56.4%），固定方法在髓内固定、螺钉加侧板固定和单纯螺钉固定之间平均分布（每种方法n = 12，30.8%）。大多数手术由中等手术量的外科医生（n = 22，56.4%）在中等及高手术量的医院进行（n = 37，94.9%）。在研究期间，该队列中观察到3例90天再入院（7.7%）、1例感染（2.6%）、1例畸形愈合（2.6%）和1例翻修手术（2.6%）。
在我们使用登记数据的系列研究中，21岁以下的髋部骨折在男孩和西班牙裔患者中更为常见。转子间骨折（德尔贝IV型）是我们基于社区的髋部骨折登记系统中最常观察到的类型。短期并发症并不常见。
