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Nonoperative Management of Pediatric Grade 1 Open Fractures With Less Than a 24-Hour Admission

Doak, Jeremy MD; Ferrick, Michael MD

doi: 10.1097/BPO.0b013e3181901c66
Trauma: Original Article

Background: The purpose of this study was to evaluate the results of nonoperative management of pediatric grade 1 open fractures treated either in the emergency room only or with a less than 24-hour admission.

Methods: A retrospective chart review was done on all patients with this type of injury who were treated by nonoperative modalities in the emergency room and who were admitted for no more than 24 hours for administration of intravenously administered antibiotics. Our population included 25 patients who were followed up until healing was confirmed clinically and radiographically.

Results: One patient with persistent serosanguineous drainage from the wound site and fever was admitted for 48 hours of intravenously administered antibiotics for presumed infection. That patient went on to heal both clinically and radiographically without further complication. Therefore, our infection rate was 4.0%.

Conclusions: This study demonstrates the safe nonoperative treatment of grade 1 open fractures in our pediatric population. This management eliminates any possible anesthetic risk as well as significantly decreases the cost of caring for these patients in the health care system.

Level of Evidence: This study was a retrospective case series and thus is classified as level IV evidence.

From the Department of Orthopaedics, State University of New York at Buffalo, Buffalo, NY.

None of the authors received financial support for this study.

Reprints: Michael Ferrick, MD, University Orthopaedic Center, 4949 Harlem Rd, Amherst, New York. E-mail: mferrick@buffalo.edu.

© 2009 Lippincott Williams & Wilkins, Inc.