Willimon Samuel C, Johnson Marjorie M, Herzog Mackenzie M, Busch Michael T
Children's Healthcare of Atlanta.
Children's Orthopaedics of Atlanta, Atlanta, GA.
J Pediatr Orthop. 2019 Jul;39(6):322-327. doi: 10.1097/BPO.0000000000000947.
Return to school among adolescents is often overlooked in orthopaedic outcome studies. The purpose was to measure the time missed from school after 10 common orthopedic surgeries.
Patients, 5 to 19 years old enrolled in elementary, middle, or high school, who underwent treatment for fixation of type III supracondylar humerus fracture, midshaft femur fracture fixation, isolated anterior cruciate ligament reconstruction, isolated partial menisectomy, adolescent idiopathic scoliosis fusion, closed reduction of both-bone forearm fracture, arthroscopic Bankart repair, hip arthroscopy with femoroacetabular impingement correction, limb length discrepancy correction, or surgical fixation of slipped capital femoral epiphysis during the 2014/2015 and 2015/2016 school years were identified for this Institutional Review Board-approved study. All patients were contacted after surgery to determine date of return to school, number of days in session, and number of school days missed.
Two hundred six patients met the inclusion criteria for this study. Mean age at time of surgery was 13.0±3.8 years. There were 105 males (51%). Mean time to return to school overall was 13.0±15.2 days. Very few students (n=9; 4%) did not miss any school days during recovery from the procedure of interest. The average number of days missed from school for males was 6.6 days compared with 8.4 days in females (P=0.20). There was no difference between patients aged 5 to 12 years compared with those aged 13 to 19 years (7.1 vs. 7.7 d, respectively; P=0.69). On average, patients who underwent closed reduction of a both-bone forearm fracture returned to school the quickest following surgery (3.4±1.2 d) and missed the least amount of in-session school days (1.9±0.9 d), and those who underwent adolescent idiopathic scoliosis fusion were out of school the longest (42.3±21.4 d) and missed the greatest number of in-session school days (27.6±14.7 d).
Information regarding average time missed from school for 10 common orthopaedic surgeries can be used by clinicians to counsel patients and their families regarding expected recovery time.
Level IV.
在骨科疗效研究中，青少年重返学校的情况常常被忽视。本研究旨在测量10种常见骨科手术后缺课的时间。
纳入2014/2015学年和2015/2016学年期间，年龄在5至19岁、就读于小学、初中或高中，因治疗Ⅲ型肱骨髁上骨折固定、股骨干骨折固定、单纯前交叉韧带重建、单纯部分半月板切除术、青少年特发性脊柱侧弯融合术、双骨前臂骨折闭合复位、关节镜下Bankart修复术、髋关节镜下股骨髋臼撞击症矫正术、肢体长度差异矫正术或股骨头骨骺滑脱手术固定的患者，进行这项经机构审查委员会批准的研究。术后与所有患者联系，确定返校日期、学期天数和缺课天数。
206例患者符合本研究的纳入标准。手术时的平均年龄为13.0±3.8岁。其中男性105例（51%）。总体平均返校时间为13.0±15.2天。在接受相关手术恢复期间，很少有学生（n = 9；4%）没有缺课。男性平均缺课天数为6.6天，女性为8.4天（P = 0.20）。5至12岁患者与13至19岁患者之间无差异（分别为7.1天和7.7天；P = 0.69）。平均而言，双骨前臂骨折闭合复位术后的患者返校最快（3.4±1.2天），缺课天数最少（1.9±0.9天），而青少年特发性脊柱侧弯融合术患者缺课时间最长（42.3±21.4天），缺课天数最多（27.6±14.7天）。
临床医生可利用10种常见骨科手术的平均缺课时间信息，为患者及其家属提供预期恢复时间的咨询。
四级。
