From the Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
J Am Acad Orthop Surg Glob Res Rev. 2020 Oct 16;4(10):e20.00170. doi: 10.5435/JAAOSGlobal-D-20-00170.
The primary objective was to evaluate whether a single educational session on casting is sufficient to reduce the rate of loss of reduction in pediatric distal radius fractures.
A retrospective review was conducted of pediatric patients with distal radius fractures casted between November 2016 and February 2019. Patients were divided into two groups: those casted by a resident who participated in a targeted education session on short arm casting and those who had not.
A total of 137 patients were included (education cohort: 61 patients and noneducation cohort: 76 patients). The two groups demonstrated similar ages and pre/post-reduction radiographic measurements. In the education cohort, 11.5% required repeat casting, wedging, or surgical intervention versus 17.1% of patients in the noneducation cohort (P = 0.47). Patients casted by residents doing one of their first three independent casts trended toward being more likely to place a cast with poor cast index and to lose reduction (P = 0.12 and P = 0.43, respectively).
A one hour education session did not reduce the need for intervention or loss of reduction. For educating residents on the skill of casting to be effective, one may consider formal feedback and evaluation throughout multiple education sessions and in early episodes of clinical care.
A Level III, Retrospective Comparative Study.
主要目的是评估单次的石膏固定教育课程是否足以降低儿童桡骨远端骨折复位丢失率。
回顾性分析了 2016 年 11 月至 2019 年 2 月期间接受石膏固定治疗的桡骨远端骨折患儿。将患儿分为两组：一组是接受过针对短臂石膏固定教育课程的住院医师进行石膏固定的患者，另一组是未接受过教育的患者。
共纳入 137 例患儿（教育组：61 例，非教育组：76 例）。两组的年龄和复位前后的影像学测量值相似。在教育组中，11.5%的患儿需要再次进行石膏固定、楔形切开或手术干预，而非教育组中这一比例为 17.1%（P = 0.47）。由住院医师进行首次独立石膏固定的前 3 次中，有更多患儿的石膏指数较差且复位丢失（P = 0.12 和 P = 0.43）。
一个小时的教育课程并不能减少干预或复位丢失的需要。为了使住院医师的石膏固定技能教育有效，可能需要在多个教育课程和早期临床护理中进行正式的反馈和评估。
III 级，回顾性比较研究。
