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美国小儿桡骨远端青枝骨折的估计发病率。

Estimated Incidence of Pediatric Distal Radius Buckle Fractures in the United States.

作者信息

Sandefur Evan P, Zainab Mosufa, Peterman Nicholas J, Kilinc Mehmet E, Yu-Shan Andrea A, Apel Peter J

机构信息

Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.

Musculoskeletal Education and Research Center, Department of Orthopaedic Surgery, Institute for Orthopaedics & Neurosciences, Carilion Clinic, Roanoke, VA, USA.

出版信息

J Pediatr Soc North Am. 2024 Jun 28;8:100075. doi: 10.1016/j.jposna.2024.100075. eCollection 2024 Aug.

Abstract

BACKGROUND

Distal radius buckle fracture care has been extensively studied, yet the incidence in the United States is unknown. This study aims to determine the incidence of pediatric buckle fractures using geospatial analysis.

METHODS

Pediatric distal radius buckle fractures (patients aged <18) from 2018 to 2022 were identified via a retrospective chart review from a single health care organization. The catchment area was defined as all of the home ZIP codes of verified buckle fracture patients. Corrections were made for buckle fractures treated at institutions with overlaying catchment areas. Adjusted incidence was then used to calculate annual buckle fractures nationally. Pediatric Orthopaedic Society of North America member rolls were used to identify and locate pediatric orthopaedic surgeons. It was assumed that each pediatric orthopaedic surgeon would treat up to 20 buckle fractures annually from a 25-mile radius of the primary office. Based on this, the percentage of buckle fractures nationally that are able to be treated by pediatric Orthopaedic surgeons was estimated.

RESULTS

A total of 594 distal radius buckle fractures over 5 years were confirmed in an estimated catchment area of 866,238 population. With adjustments for overlapping institutions, the estimated annual incidence was 17.3 per 100,000 people (95% CI [14.5, 20.1]). In the United States, there are an estimated 66,513 buckle fractures annually, with 1,182 pediatric orthopaedic surgeons potentially able to treat 26.5% of these cases.

CONCLUSIONS

This investigation estimates the incidence of pediatric buckle fractures in the United States, allowing for estimates of expected volumes and implications for care. Based on the geographic distribution of pediatric orthopaedic surgeons and estimated incidence, it is impractical for buckle fracture care to be delivered exclusively by pediatric orthopaedic surgeons.

KEY CONCEPTS

(1)The estimated annual incidence of distal radius buckle fracture is 17.3 per 100,000 people.(2)Pediatric orthopaedic surgeons are able to treat up to 26.5% of these cases.(3)Buckle fractures cannot be the exclusive domain of pediatric orthopaedic surgeons, as the number of pediatric Orthopaedic surgeons is too small for them to be the sole providers of care.

LEVEL OF EVIDENCE

III.

摘要

背景

桡骨远端青枝骨折的治疗已得到广泛研究,但美国的发病率尚不清楚。本研究旨在通过地理空间分析确定儿童青枝骨折的发病率。

方法

通过对一家医疗保健机构的回顾性病历审查,确定2018年至2022年的儿童桡骨远端青枝骨折(年龄<18岁的患者)。集水区定义为经证实的青枝骨折患者的所有家庭邮政编码。对在集水区重叠的机构治疗的青枝骨折进行了校正。然后使用校正后的发病率计算全国每年的青枝骨折发生率。利用北美小儿骨科学会成员名单来识别和定位小儿骨科医生。假设每位小儿骨科医生每年在其主要办公室半径25英里范围内最多治疗20例青枝骨折。基于此,估计了全国范围内小儿骨科医生能够治疗的青枝骨折的百分比。

结果

在估计人口为866,238的集水区内,5年中共确诊594例桡骨远端青枝骨折。经过对重叠机构的校正后,估计年发病率为每10万人17.3例(95%CI[14.5,20.1])。在美国,估计每年有66,513例青枝骨折,有1182名小儿骨科医生可能能够治疗其中的26.5%。

结论

本调查估计了美国儿童青枝骨折的发病率,从而可以估计预期病例数及其对治疗的影响。基于小儿骨科医生的地理分布和估计发病率,仅由小儿骨科医生提供青枝骨折治疗是不切实际的。

关键概念

(1)桡骨远端青枝骨折的估计年发病率为每10万人17.3例。(2)小儿骨科医生能够治疗其中高达26.5%的病例。(3)青枝骨折不能仅由小儿骨科医生负责,因为小儿骨科医生数量太少,无法成为唯一的治疗提供者。

证据级别

III级

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