Chan C F, Meads B M, Nicol R O
Department of Paediatric Orthopaedics, Starship Children's Hospital, Auckland.
N Z Med J. 1997 Jul 11;110(1047):249-50.
To determine whether operator experience or time of operation affects the outcome of fractures of the forearm in the paediatric age group as measured by the need for remanipulation.
A retrospective analysis of 1155 children with forearm fractures requiring manipulation was undertaken.
The remanipulation rate for these 1155 children was 136 or 11.7%. There was a significant difference in those fractures requiring remanipulation dependent upon the experience of the operator and the time of day the procedure was performed. The lowest rate of remanipulation was obtained by senior registrars operating between the hours of 0800-1700 (6/113 or 5.3%). The highest rate was found to be junior registrars between the hours of 1700-2200 (39/167 or 23.3%). It is especially interesting to note the relatively low rate (31/437 or 7.1%) obtained by junior registrars during the night shift (2200-0800 hours).
The current overall remanipulation rate is acceptable. The low rate between 2200-0800 hours means rescheduling of these patients is unnecessary. The rate for junior registrars between 1700-2200 hours needs to be improved.
