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Increasing Rate of Surgical Fixation in Four- and Five-year-old Children With Femoral Shaft Fractures

Alluri, Ram Kiran, MD; Sabour, Andrew, BS; Heckmann, Nathanael, MD; Hatch, George F., MD; VandenBerg, Curtis, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 01, 2019 - Volume 27 - Issue 1 - p e24–e32
doi: 10.5435/JAAOS-D-17-00064
Research Article

Background: The purpose of this study was to identify temporal trends in the management of pediatric femoral shaft fractures in 4- and 5-year-old children.

Methods: The Kids' Inpatient Database was used to extract data on patients aged 4 and 5 years with closed femoral shaft fractures. The frequency of nonsurgical and surgical management was calculated, and temporal trends were evaluated.

Results: Between 1997 and 2012, the absolute increase in surgical fixation was 35% and 58% in 4- and 5-year-old patients, respectively. The surgical rate increased every 3 years by 13.8% in 4-year-old patients and 7.6% in 5-year-old patients. Significant associations were noted based on demographics, comorbidities, and hospital characteristics with management decisions.

Conclusions: A clear and significant increase was noted in internal fixation for pediatric femoral shaft fractures in 4- and 5-year-old children, and the lower age limit for surgical management of these fractures is decreasing.

Level of Evidence: Level III. Retrospective comparative study

From the Keck School of Medicine of the University of Southern California, Los Angeles, CA.

Correspondence to Dr. Alluri:

Dr. Alluri or an immediate family member has stock or stock options held in AxoGen, Stryker, and Zimmer Biomet and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non–research-related funding (such as paid travel) from Acumed, Arthrex, and Trimed. Dr. Heckmann or an immediate family member has stock or stock options held in Masimo, Materialise NV, and NuVasive. Dr. Hatch or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Arthrex and serves as a paid consultant to Arthrex. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Sabour and Dr. VandenBerg.

© 2019 by American Academy of Orthopaedic Surgeons
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