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a novel approach for the treatment of nondisplaced pediatric elbow fractures

Silva, Mauricioa,,b; Delfosse, Erin M.a; Aceves-Martin, Biankaa; Scaduto, Anthony A.a,,b; Ebramzadeh, Edwarda,,b

Journal of Pediatric Orthopaedics B: November 2019 - Volume 28 - Issue 6 - p 542–548
doi: 10.1097/BPB.0000000000000576

Telehealth has seldom been used in the field of pediatric orthopaedics. The purpose of this study is to assess the efficacy of telehealth as a tool for the follow-up of children with nondisplaced elbow fractures. We hypothesize that patients treated via telehealth will have comparable clinical outcomes as those treated at our institution, with increased patient satisfaction. We conducted a randomized trial, which included 52 children with type I supracondylar humeral fractures, or occult elbow injuries, divided in two groups, based on the type of care provided during the fourth-week follow-up appointment: cast removal at our institution (group A) or cast removal at home via telehealth appointment (group B). The time duration and professional fees for this week 4 follow-up were calculated. Patients in both groups returned to our institution for a final follow-up in week 8. We measured the amount of fracture displacement, range of motion, pain, and patient satisfaction. There was no statistically significant difference in fracture displacement, range of motion, or pain scores between groups. The mean length of the fourth-week clinical encounter was higher in group A than group B (47.2 vs. 17.6 min, respectively; P < 0.001). Initially, the mean patient satisfaction scores were nearly identical in both groups (97%) until patients in group A were made aware of this difference in time duration, at which their mean satisfaction score decreased to 76.4% (P = 0.05). The use of telehealth as a tool in the treatment of nondisplaced pediatric elbow fractures is appealing. Patients managed via telehealth had higher satisfaction rates and spent only a third of the time for their clinical encounter.

aOrthopaedic Institute for Children

bDepartment of Orthopaedics, David Geffen School of Medicine, UCLA/Orthopaedic Hospital, University of California, Los Angeles, California, USA

Correspondence to Mauricio Silva, MD, Orthopaedic Institute for Children, Los Angeles, CA 90007, USA Tel: + 1 213 742 1369; fax: + 1 213 742 1583; e-mail:

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