TY - JOUR
T1 - Change in treatment preferences in pediatric diaphyseal forearm fractures: a Danish nationwide register study of 36,244 fractures between 1997 and 2016
AU - Hansen, Rasmus T.
AU - Borghegn, Nicolas W.
AU - Gundtoft, Per Hviid
AU - Nielsen, Katrine A.
AU - Balslev-Clausen, Andreas
AU - Viberg, Bjarke
N1 - Publisher Copyright: © 2023 The Author(s).
PY - 2023
Y1 - 2023
N2 - Background and purpose — The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period. Patients and methods — This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramed-ullary nailing [IMN], and open reduction internal fixation [ORIF]). The secondary outcomes were further sub-analyses on invasive treatment and age groups. Results — 36,244 diaphyseal forearm fractures were investigated, yielding a mean incidence of 172 per 105/year. The proportion of fractures treated invasively increased from 1997 to 2016, from 4% to 23%. The use of Kirschner wires increased from 1% to 9%, IMN increased from 1% to 14%, and ORIF decreased from 2% to 1%. The changes were evi-dent in all age groups but smaller in the 0–3-year age group. Conclusion — We found an increase in invasive treatment of pediatric diaphyseal forearm fractures over the investigated period. A change in invasive methods was also found, as the rate of IMN increased over the investigated period and became the predominant surgical treatment choice.
AB - Background and purpose — The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period. Patients and methods — This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramed-ullary nailing [IMN], and open reduction internal fixation [ORIF]). The secondary outcomes were further sub-analyses on invasive treatment and age groups. Results — 36,244 diaphyseal forearm fractures were investigated, yielding a mean incidence of 172 per 105/year. The proportion of fractures treated invasively increased from 1997 to 2016, from 4% to 23%. The use of Kirschner wires increased from 1% to 9%, IMN increased from 1% to 14%, and ORIF decreased from 2% to 1%. The changes were evi-dent in all age groups but smaller in the 0–3-year age group. Conclusion — We found an increase in invasive treatment of pediatric diaphyseal forearm fractures over the investigated period. A change in invasive methods was also found, as the rate of IMN increased over the investigated period and became the predominant surgical treatment choice.
KW - Diaphyseal forearm fracture
KW - Epidemiology
KW - Fractures
KW - Paediatric orthopaedics
UR - http://www.scopus.com/inward/record.url?scp=85147581839&partnerID=8YFLogxK
U2 - 10.2340/17453674.2023.7132
DO - 10.2340/17453674.2023.7132
M3 - Journal article
C2 - 36727711
SN - 1745-3690
VL - 94
SP - 32
EP - 37
JO - Acta Orthopaedica. Supplementum (Print Edition)
JF - Acta Orthopaedica. Supplementum (Print Edition)
ER -