Variation Among Pediatric Orthopaedic Surgeons When Treating Medial Epicondyle Fractures

Journal of Pediatric Orthopedics
Meghan HughesJoshua M Abzug

Abstract

Medial epicondyle fractures are a common pediatric and adolescent injury accounting for 11% to 20% of elbow fractures in this population. This purpose of this study was to determine the variability among pediatric orthopaedic surgeons when treating pediatric medial epicondyle fractures. A discrete choice experiment was conducted to determine which patient and injury attributes influence the management of medial epicondyle fractures by pediatric orthopaedic surgeons. A convenience sample of 13 pediatric orthopaedic surgeons reviewed 60 case vignettes of medial epicondyle fractures that included elbow radiographs and patient/injury characteristics. Displacement was incorporated into the study model as a fixed effect. Surgeons were queried if they would treat the injury with immobilization alone or open reduction and internal fixation (ORIF). Statistical analysis was performed using a mixed effect regression model. In addition, surgeons filled out a demographic questionnaire and a risk assessment to determine if these factors affected clinical decision-making. Elbow dislocation and fracture displacement were the only attributes that significantly influenced surgeons to perform surgery (P<0.05). The presence of an elbow dislocation...Continue Reading

References

Sep 25, 2001·The Journal of Bone and Joint Surgery. American Volume·P FarsettiE Ippolito
Mar 25, 2005·Journal of Shoulder and Elbow Surgery·Hsieh-Hsing LeeShing-Sheng Wu
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Apr 5, 2012·The Journal of the American Academy of Orthopaedic Surgeons·Hilton P GottschalkHarish S Hosalkar
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Dec 11, 2014·Journal of Pediatric Orthopedics·Eric W EdmondsKatherine R Saul
Jan 8, 2015·Current Opinion in Pediatrics·Rubini Pathy, Emily R Dodwell

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Citations

Jul 23, 2020·Journal of Pediatric Orthopedics. Part B·Serafín García-MataDaniel Sánchez-Guardamino
Mar 19, 2021·Journal of Pediatric Orthopedics·Soroush BaghdadiJohn T R Lawrence

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