Frysch, C.W.S. (Christian) (2017) A closer look at follow-up: Do we need orthopaedic follow-up on every paediatric clavicle fracture? A retrospective review. thesis, Medicine.
Full text available on request.Abstract
Objective: For the past decades, treatment and follow-up for clavicle fractures in children has been the subject of discussion. This research functions as a pilot study and will provide a thorough assessment of the current population, treatment approaches and follow-up care in order to create an evidence-based treatment protocol and reduce unnecessary follow-up visits after a clavicle fracture. Methods: This is a retrospective analysis of all children and adolescents with a clavicle fracture seen at BC Children’s Hospital (Vancouver, Canada) from 2010 to 2014. Patient files were searched for demographic, injury, treatment, outcome and follow-up data. All available clavicular radiographs were assessed for angulation, displacement, shortening and comminution. Results: 406 (264 males, 142 females) patients with a mean age of 7.9 (95% CI: 7.4-8.4) were recorded. Orthopaedic clinic follow-up took place in 95 (23.4%) patients. 149 (36.7%) of patients received radiographic follow-up. The mean length of follow-up was 7.4 (95% CI: 6- 8.8) weeks compared to 2.7 (95% CI: 2.2-3.3) weeks for the whole population. During followup the treatment was only changed in 8 (2.2%) patients. Most fractures were not followed-up until union was established (96.6%). 27 complications developed in 23 (5.7%) patients, who were seen in the emergency room (n=19) or orthopaedic clinic (n=8). These included no malor nonunions, but 5 refractures occurred. Only 3 complications warranted treatment change. 5 (1.2%) patients were treated surgically with 2 complications in the follow-up. Conclusions: These results suggest that complication rate is low and neither orthopaedic clinic, nor radiographic follow-up prevents them from occurring. However, outcomes are not comparable as they were measured at different times depending on the last follow-up visit. Surgeries are also rare and their indications are identified within the first 10 days of initial presentation. Further research needs to be performed in a prospective setting with a gapless documentation in order to validate the findings.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: Dr. P.G.M. Maathuis |
| Supervisor name: | Second supervisor: and Mulpuri, Dr. Kishore and Department of Orthopaedic Surgery, BC Children’s Hospital and Vancouver, British Columbia |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1070 |
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