Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark.
Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital Kolding, University Hospital of Southern Denmark; Department of Orthopaedic Surgery and Traumatology, Aarhus University Hospital.
Acta Orthop. 2023 Feb 1;94:32-37. doi: 10.2340/17453674.2023.7132.
The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period. Patients and methods: This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramedullary nailing [IMN], and open reduction internal fixation [ORIF]). The secondary outcomes were further sub-analyses on invasive treatment and age groups.
36,244 diaphyseal forearm fractures were investigated, yielding a mean incidence of 172 per 105/year. The proportion of fractures treated invasively increased from 1997 to 2016, from 4% to 23%. The use of Kirschner wires increased from 1% to 9%, IMN increased from 1% to 14%, and ORIF decreased from 2% to 1%. The changes were evident in all age groups but smaller in the 0-3-year age group.
We found an increase in invasive treatment of pediatric diaphyseal forearm fractures over the investigated period. A change in invasive methods was also found, as the rate of IMN increased over the investigated period and became the predominant surgical treatment choice.
儿童骨干前臂骨折的侵入性与非侵入性治疗选择可能较为困难。我们研究了 20 年来儿童骨干前臂骨折治疗选择的变化趋势。
这是一项基于人群的注册研究，数据来自 1997 年至 2016 年的丹麦国家患者登记处。主要结局为 1 周内的主要治疗选择，分为非侵入性治疗（仅石膏或闭合复位加石膏）和侵入性治疗（克氏针、髓内钉和切开复位内固定）。次要结局为进一步对侵入性治疗和年龄组进行亚分析。
研究了 36244 例骨干前臂骨折，平均发病率为每 105/年 172 例。侵入性治疗的比例从 1997 年到 2016 年从 4%增加到 23%。克氏针的使用从 1%增加到 9%，髓内钉从 1%增加到 14%，切开复位内固定从 2%减少到 1%。这些变化在所有年龄组中都很明显，但在 0-3 岁年龄组中较小。
我们发现研究期间儿童骨干前臂骨折的侵入性治疗有所增加。还发现了侵入性治疗方法的变化，因为髓内钉的使用率在研究期间有所增加，并成为主要的手术治疗选择。
