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急诊科小儿髁上骨折的综合分析:单中心经验

Comprehensive Analysis of Pediatric Supracondylar Fractures in the Emergency Department; A Single Center Experience.

作者信息

Ausó-Pérez José Ramón, Rodríguez-Blanes Gloria María

机构信息

Orthopedic Surgery and Traumatology Services, Hospital Marina Baixa, Alicante, Spain.

Occupational Health Unit, Public Health Center of Alcoy, Alicante; Conselleria of Universal Health and Public Health, Generalitat Valenciana, Spain.

出版信息

Bull Emerg Trauma. 2020 Jul;8(3):142-147. doi: 10.30476/BEAT.2020.83195.

Abstract

OBJECTIVE

To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures.

METHODS

This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ED of a regional hospital in Spain. We have included all the pediatric patients (<14 years) with supracondylar fractures referring to our center during the study period. The demographic, clinical and radiological characteristics of the patients were recorded. The outcome and treatment strategies were also recorded. The risk factors of the pediatric supracondylar fracture was also assessed in our series.

RESULTS

We have included 52 pediatric patients with supracondylar fractures in this series. The mean age was 7.48 ± 2.97 years with a minimum age of 2 years and a maximum of 14 years. Among the patients there were 32 (61.54%) male and 20 (38.46%) female. Age less than 7 years found to be a protective factor against unstable fractures [OR 0.33 (0.10 - 1.02)]. Fractures presented during daytime hours showed a greater instability [OR 3.49 (1.07-11.39)]. However, the risk of presentation at nighttime was higher during the summer months (June to September).

CONCLUSION

The older is the child, the greater is the risk of suffering an unstable fracture, which increases the need for surgery. This risk is greater during the daytime. Otherwise, during the summer months, there is a higher risk of patient presentation at nighttime.

摘要

目的

描述小儿肱骨髁上骨折患者的人口统计学特征,并评估与在急诊科就诊时间相关的可能危险因素。

方法

这是一项横断面研究,于2013年至2017年期间在西班牙一家地区医院的急诊科进行。我们纳入了研究期间转诊至本中心的所有小儿(<14岁)髁上骨折患者。记录患者的人口统计学、临床和放射学特征。还记录了结局和治疗策略。我们的系列研究中也评估了小儿髁上骨折的危险因素。

结果

本系列研究纳入了52例小儿髁上骨折患者。平均年龄为7.48±2.97岁,最小年龄2岁,最大年龄14岁。患者中男性32例(61.54%),女性20例(38.46%)。年龄小于7岁被发现是预防不稳定骨折的保护因素[比值比0.33(0.10 - 1.02)]。白天出现的骨折显示出更大的不稳定性[比值比3.49(1.07 - 11.39)]。然而,夏季月份(6月至9月)夜间就诊的风险更高。

结论

儿童年龄越大,发生不稳定骨折的风险越高,这增加了手术需求。白天这种风险更大。此外,在夏季月份,患者夜间就诊的风险更高。

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本文引用的文献

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Pediatric Orthopedic Trauma: An Evidence-Based Approach.小儿骨科创伤:循证医学方法
Orthop Clin North Am. 2018 Apr;49(2):195-210. doi: 10.1016/j.ocl.2017.11.008. Epub 2017 Dec 14.
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Fracture Supracondylar Humerus: A Review.肱骨髁上骨折:综述
J Clin Diagn Res. 2016 Dec;10(12):RE01-RE06. doi: 10.7860/JCDR/2016/21647.8942. Epub 2016 Dec 1.

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