![]() ![]() Nineteen patients (4.9%) required either cast splitting (15) or strict elevation (4) secondary to pain and swelling. Of these 387 patients, 369 (95.3%) had an uneventful postoperative course. Forty-three patients had preoperative nerve palsy and 1 had preoperative vascular injury. There were 387 patients who met inclusion criteria, including 204 type 2 fractures and 183 type 3 fractures. Patients with open reduction, ipsilateral fractures, or patients lost to follow-up were excluded. All complications or the need for cast modification were noted. The purpose of this study was to evaluate the safety, efficacy, and complications associated with acute placement of this definitive cast after closed reduction percutaneous pinning (CRPP) of acute supracondylar distal humerus fractures.Ī retrospective medical record reviewed 436 patients treated with CRPP of supracondylar fractures by 3 surgeons who routinely used an A-frame cast over a 12-year period. We have developed a novel casting method (A-frame cast) that allows cast placement while leaving the antecubital fossa free of casting material. March 88(3):362-5.Circumferential casts can contribute to elevated compartment pressures in the setting of acute swelling. Supracondylar humeral fractures in children: ten years’ experience in a teaching hospital. Risk of infection and secondary displacement in pediatric supracondylar or lateral condyle fractures treated with unburied Kirchener-wires removed before complete bone healing. May-Jun 38(5):e245-51.Īubret S, Lecointe T, Mansour M, Rousset M, Andreacchio A, Pereira B, Charles YP, Canavese F. Understanding the epidemiology of pediatric supracondylar humeral fractures in the United States: identifying opportunities for intervention. national trends in the treatment of pediatric supracondylar humeral fractures. Holt JB, Glass NA, Bedard NA, Weinstein SL, Shah AS. Limb fracture pattern in different pediatric age groups: a study of 3,350 children. See Instructions for Authors for a complete description of levels of evidence.Ĭheng JC, Shen WY. Physicians are encouraged to reevaluate their daily practice to identify safe opportunities for resource preservation. We anticipate that this could preserve approximately 20,000 gowns and masks in the United States over the next year. Data from this large series suggest that a semisterile technique during CRPP of supracondylar humeral fractures is a safe practice. We currently face critical shortages of PPE due to the COVID-19 pandemic. It is estimated that national adoption of this technique in the United States could save between 18,612 and 22,162 gowns and masks with costs savings of $3.7 million to $4.4 million annually. There were no known surgeon occupational exposures to bodily fluid. No clinically relevant pin-track infections were noted. These infections all occurred in the group using full sterile preparation and surgical masks. In this study, 1,270 patients who underwent CRPP of a supracondylar humeral fracture and met inclusion criteria were identified. Hospital cost data were used to estimate annual cost savings with the adoption of the semisterile technique. We additionally analyzed a subgroup of patients who had semisterile preparation without surgeon mask use. Infectious outcomes were compared between 2 groups: full sterile preparation and semisterile preparation. ![]() One surgeon in the group did not wear a mask when performing CRPP of supracondylar humeral fractures, and multiple surgeons in the group utilized a semisterile preparation technique (no sterile gown or drapes). This is a retrospective chart review of 1,270 patients treated with CRPP of a supracondylar humeral fracture at 2 metropolitan pediatric centers by 10 fellowship-trained pediatric orthopaedic surgeons. ![]() This is of particular interest in the current climate as we face unprecedented PPE shortages due to the current COVID-19 pandemic. The use of full, standard preparation and draping with standard personal protective equipment (PPE) may not be necessary during this procedure. Closed reduction and percutaneous pinning (CRPP) of supracondylar humeral fractures is one of the most common procedures performed in pediatric orthopaedics. ![]()
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