TY - JOUR

T1 - Change in treatment preferences in pediatric diaphyseal forearm fractures

T2 - 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 - Funding Information: The authors of this study had full access to all data and, due to Danish legislation, the authors are not able to share the raw data but can by request provide further data. We received funding from the Research Council of Hospital Lillebaelt to establish a large fracture cohort but not directly for this study. There are no conflicts of interest related to this study. BV has, 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

U2 - 10.2340/17453674.2023.7132

DO - 10.2340/17453674.2023.7132

M3 - Journal article

C2 - 36727711

AN - SCOPUS:85147581839

VL - 94

SP - 32

EP - 37

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

ER -