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Is less more? Assessing the utility of early clinical and radiographic follow-up for operative supracondylar humerus fractures.
Thompson, R M; Hubbard, E W; Elliott, M; Riccio, A I; Sucato, D J.
Afiliación
  • Thompson RM; Department of Orthopaedic Surgery, Orthopaedic Institute for Children/UCLA, Los Angeles, California, USA.
  • Hubbard EW; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
  • Elliott M; Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.
  • Riccio AI; Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.
  • Sucato DJ; Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.
J Child Orthop ; 12(5): 502-508, 2018 Oct 01.
Article en En | MEDLINE | ID: mdl-30294376
PURPOSE: Postoperative protocols following surgical management of supracondylar humerus fractures (SCFs) are often based upon surgeon preference rather than clinical merit. The purpose of this study is to determine the utility of early clinical and radiographic follow-up. METHODS: A retrospective review of patients who underwent closed reduction and percutaneous pinning (CRPP) for SCF between 2009 and 2015 was performed using a database of prospectively-collected consecutive patient data. Previously undiagnosed neuropathies documented at the first postoperative visit were identified. Unscheduled visits and postoperative complications were compared between patients who were seen at one week and those with delayed first clinic visits. RESULTS: Of 873 patients, 823 (94.3%) were seen within ten days of surgery (early follow-up) and 50 (5.7%) had a delayed first clinic appointment. Among patients seen for early follow-up, 12 (1.5%) had a previously undocumented neuropathy diagnosed but only eight (1%) had an alteration of management secondary to clinical findings. Greater than 90% of patients seen for early follow-up had radiographs performed, but only one had an alteration in management due to radiographic findings. Patients seen for early follow-up had the same rate of unscheduled visits (2.9% versus 4%, p = 0.66) and postoperative complications (1.6% versus 0%, p > 0.99) as those with delayed first appointments. Radiographic parameters were comparable at final follow-up (Baumann's angle 74.5° versus 73.7°, p = 0.40; lateral humeral condylar angle 40.2° versus 41.2°, p = 0.53). CONCLUSION: The early follow-up visit after CRPP of SCF rarely leads to alterations in care and does not reduce unscheduled visits or late complications. LEVEL OF EVIDENCE: Level IV.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Prognostic_studies Idioma: En Revista: J Child Orthop Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Prognostic_studies Idioma: En Revista: J Child Orthop Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido