Treatment preferences of orthopedic surgeons for closed, isolated middle-third diaphyseal long bone fractures without neurovascular injury in children: A crosssectional survey
Treatment preferences of orthopedic surgeons for closed, isolated middle-third diaphyseal long bone fractures without neurovascular injury in children: A crosssectional survey
closed, isolated, middle-third diaphyseal long bone fractures without any neurovascular injury in children. Methods: This was a cross-sectional electronic survey of Turkish Orthopaedic Surgeons who were active members of the Turkish Society of Children’s Orthopaedics (TSCO) and still managing the children’s fractures in their daily clinical practice. An initial e-mail including the electronic survey followed by three reminder e-mails was sent to 110 members, and then reminder telephone calls were made. Results: The survey response rate was 66/110 (60%). In recent years, a definitive trend to surgical treatment was not seen 98%, 77%, 39%, and 88% of the responders in the closed humerus, forearm, femur, and tibia mid-shaft fractures, respectively. Neither the years of expertise nor the intensity of daily pediatric patients of the participants did not affect the treatment trend in any fracture scenarios. The patient’s age was the most cited factor influencing the responders’ decisions on whether conservative or surgical treatment would be performed in each fracture scenario. The most cited lowest age limits for surgical treatment inclosed mid-shaft fractures of the humerus, forearm, femur, and tibia, were the adolescent age group, 10-12 years, six years, and ten years, respectively. Conclusion: This is the first study assessing the daily clinical practice of members of TSCO in the management of closed, isolated, noncomplicated middle-third diaphyseal long bone fractures in children just before the covid-19 pandemic started. A marked tendency toward surgical treatment is seen in femur mid-shaft fractures, followed by forearm mid-shaft fractures up to a certain level. The patient’s age is the main determinant of the responders’ decisions on the type of treatment in closed, isolated, non-complicated middle-third diaphyseal long bone fractures in children.
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- 1. Brighton B, Vitale M. Epidemiology of fractures in children. In: Flynn JM, Skaggs DL, Waters PM, eds. Rockwood and Wilkins’ Fractures in Children. 8th ed. Philadelphia: Wolters Kluwer; 2015:1-17.
- 2. Ömeroğlu H. Basic principles of fracture treatment in children. Eklem Hastalik Cerrahisi. 2018;29(1):52-57. [CrossRef]
- 3. Helenius I, Lamberg TS, Kääriäinen S, Impinen A, Pakarinen MP. Operative treatment of fractures in children is increasing. A population-based study from Finland. J Bone Joint Surg Am. 2009;91(11):2612-2616. [CrossRef]
- 4. Ömeroğlu H,Cassiano Neves M. Tendency towards operative treatment is increasing in children’s fractures: results obtained from patient databases, causes, impact of evidence- based medicine. EFORT Open Rev. 2020;5(6):347- 353. [CrossRef]
- 5. Social Science Statistics www.socscistatistics.com. Last Visited September 5th, 2021.
- 6. Kalem M, Özbek EA, Kocaoğlu H, et al. The increase in paediatricorthopaedic trauma injuries following the end of the curfew during the COVID-19 period[CrossRef]J Child Orthop. 2021;15:409-414.
- 7. Turgut A, Arlı H, Altundağ Ü, Hancıoğlu S, Egeli E, Kalenderer Ö. Effect of COVID-19 pandemic on the fracture demographics: data from a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc. 2020;54(4):355-363. [CrossRef]
- 8. Hannonen J, Sassi E, Hyvönen H, Sinikumpu JJ. A shift from non-operative care to surgical fixation of pediatric humeral shaft fractures even though their severity has not changed. Front Pediatr. 2020;8. [CrossRef]
- 9. Wenger DR, Pring ME. Rang’s Children’s Fractures. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
- 10. Sinikumpu JJ. Too many unanswered questions in children’s forearm shaft fractures: high standart epidemiological and clinical research in pediatric trauma is warranted. Scand J Surg. 2015;104(3):137-138. [CrossRef]
- 11. Sinikumpu JJ, Victorzon S, Antila E, Pokka T, Serlo W. Nonoperatively treated forearm shaft fractures in children show good long-term recovery.Acta Orthop. 2014;85(6):620-625. [CrossRef]
- 12. Hubbard EW, Riccio AI. Pediatric orthopedic trauma. An evidence-based approach. Orthop Clin North Am. 2018;49(2):195-210. [CrossRef]
- 13. Von Heideken Jv, Svensson T, Blomqvist P, Haglund-Åkerlind Y, Janarv PM. Incidence and trends in femur shaft fractures in Swedish children between 1987 and 2005. J Pediatr Orthop. 2011;31(5):512-519. [CrossRef]
- 14. Stenroos A, Puhakka J, Nietosvaara Y, Kosola J. Treatment of closed tibia shaft fractures in children: a systematic review and meta-analysis.Eur J Pediatr Surg. 2020;30(6):483-489. [CrossRef]
- 15. Kleiner JE, Raducha JE, Cruz Jr AI. Increasing rates of surgical treatment for pediatric shaft fractures: a national database study from 2000 and 2012. J Child Orthop. 2019;13(2):213-219. [CrossRef]