大多数儿童移位性胫骨结节骨折的门诊手术治疗是安全有效的。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-11-16 eCollection Date: 2023-12-01 DOI:10.1177/18632521231214317
Brian Kendrick Zukotynski, Danielle Brown, Kellyn Hori, Mauricio Silva
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引用次数: 0

摘要

目的:本研究的目的是比较手术治疗的移位性胫骨结节骨折患者术后在医院度过一个或多个晚上与在门诊治疗的患者没有围手术期住院治疗的结果。我们假设胫骨结节骨折并发症发生率低,大多数患者不需要住院观察。方法:我们回顾性地回顾了13.5年来由同一位外科医生手术治疗的所有儿童胫骨结节骨折。在住院环境中治疗的骨折,定义为术后至少住院一晚,与在非围手术期住院的门诊环境中治疗的骨折进行比较。结果:对70例患者71例骨折进行分析。所有骨折均行切开复位内固定单皮质螺钉治疗。35例骨折(49.3%)在门诊固定,36例(50.7%)住院。住院患者人口统计数据(年龄、性别、体重指数、骨折类型)之间无显著差异。住院组平均手术时间明显长于门诊组(97.8 min vs 58.8 min)。结论:门诊手术治疗选择性胫骨结节骨折当日出院安全有效。并非所有手术治疗的胫骨结节骨折患者都需要在医院过夜。
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Ambulatory surgical management of most displaced tibial tubercle fractures in children is safe and efficient.

Purpose: The purpose of this study is to compare the outcome of patients with displaced tibial tubercle fractures treated surgically who spent one or more nights in the hospital after surgery with that of patients treated in an ambulatory setting with no perioperative hospitalization. We hypothesized that tibial tubercle fractures have a low rate of complications and that most patients do well without an overnight hospital stay for observation.

Methods: We retrospectively reviewed all pediatric tibial tubercle fractures treated operatively by a single surgeon over a 13.5-year period. Fractures treated in an inpatient setting, defined as at least one night of overnight hospitalization postoperatively, were compared with fractures treated in an ambulatory setting with no perioperative hospitalization.

Results: Seventy-one fractures in 70 patients were analyzed. All fractures were treated with open reduction and internal fixation with unicortical screws. Thirty-five fractures (49.3%) were fixed in an ambulatory setting, while 36 (50.7%) were inpatient. There were no significant differences between inpatient demographics (age, gender, body mass index, fracture type). Average operative time was significantly longer in the inpatient group compared with the ambulatory group (97.8 min versus 58.8 min, p < 0.001). There was no significant difference in the incidence of complications between inpatient and ambulatory groups (25.0% versus 11.4%, p = 0.22). No cases of compartment syndrome were noted.

Conclusion: Ambulatory surgical treatment of select tibial tubercle fractures with same-day discharge is safe and efficient. Not all patients with surgically treated tibial tubercle fractures need to stay overnight in the hospital.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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