Changing practice patterns: the impact of a randomized clinical trial on surgeons preference for treatment of type 3 supracondylar humerus fractures

Journal of Pediatric Orthopedics
Susan T MahanM Timothy Hresko

Abstract

A recent prospective randomized clinical trial (RCT) for comparison of medial and lateral entry pins with lateral entry pins for treatment of Gartland type 3 supracondylar humerus fractures (SCHF) was published, validating the national trend toward treatment of this injury with only lateral entry pins. But have surgeons actually changed their practice as a result of these recent data? The purpose of this study was to compare pin configuration, loss of reduction and rate of nerve injuries before and after the RCT. This was a retrospective review of patients with Gartland type 3 SCHF who were treated before the RCT (April 2000 to April 2003: 141 patients) and after the trial (April 2006 to April 2009: 126 patients). Eight surgeons were included. Patient demographic data, pin configuration, neurovascular status, and radiographic results were compared. Comparisons between the pretrial cohort and the posttrial cohort as a group as well as for each individual surgeon were performed. Comparisons included the choice of pin configuration, incidence of loss of radiographic reduction, iatrogenic nerve injuries, return to the operating room, and infection before and after the clinical trial. There was a statistically different pin configur...Continue Reading

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Citations

Apr 24, 2013·Journal of Orthopaedic Trauma·Hassan KhanMohit Bhandari
Sep 11, 2019·Journal of Pediatric Orthopedics·Benjamin J ShorePeter M Waters
Jun 28, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Grace X XiongJulius A Bishop

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