Increased open fracture complications following pediatric all-terrain vehicle accidents.


Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Oct 2022
Historique:
received: 09 03 2022
revised: 11 07 2022
accepted: 06 08 2022
pubmed: 29 8 2022
medline: 28 9 2022
entrez: 28 8 2022
Statut: ppublish

Résumé

ATV (All-Terrain Vehicle) related open fractures are often high energy and may be highly contaminated. We asked whether they were more complicated than other open fractures in pediatric patients. A retrospective chart review was performed comparing ATV associated open fractures to open fractures sustained in non-ATV related accidents. 97 pediatric open fractures from 2015 to 2021 were identified based on ICD-10 codes. Of these fractures, 62 were non-ATV related and 35 were ATV related. Charts were reviewed to collect basic demographics, fracture pattern, Gustilo-Anderson classification, procedures performed, operative findings, and complications. Our cohort was predominantly male (71% in the ATV group and 76% in the non-ATV group). White race was more common in both the ATV (28 (80%)) and non-ATV (50(78%)) groups. The distribution of AO/OTA fractures was significantly different (p = 0.046), with humerus fractures being more common in the ATV group (8 (22%)) vs. non-ATV group (6 (9.3%)). The ATV group had a higher proportion of more severe type II and III open fractures with 77.1% (n = 27), versus 56% (n = 35) in the non-ATV group (p = 0.020).. Revision and reoperation were more likely in the ATV group (16 (23%)) vs. the non-ATV group (12 (15%)), as was malunion (ATV group 3 (4.3%) Vs. non-ATV 0 (0%)). Open fractures resulting from ATV injuries tend to be more complex and have higher rates of revision and malunion. This information supports the large body of evidence on the dangers of ATVs to children and can help guide expectations of both clinicians and family members of patients presenting with these injuries.

Sections du résumé

BACKGROUND BACKGROUND
ATV (All-Terrain Vehicle) related open fractures are often high energy and may be highly contaminated. We asked whether they were more complicated than other open fractures in pediatric patients.
METHODS METHODS
A retrospective chart review was performed comparing ATV associated open fractures to open fractures sustained in non-ATV related accidents. 97 pediatric open fractures from 2015 to 2021 were identified based on ICD-10 codes. Of these fractures, 62 were non-ATV related and 35 were ATV related. Charts were reviewed to collect basic demographics, fracture pattern, Gustilo-Anderson classification, procedures performed, operative findings, and complications.
RESULTS RESULTS
Our cohort was predominantly male (71% in the ATV group and 76% in the non-ATV group). White race was more common in both the ATV (28 (80%)) and non-ATV (50(78%)) groups. The distribution of AO/OTA fractures was significantly different (p = 0.046), with humerus fractures being more common in the ATV group (8 (22%)) vs. non-ATV group (6 (9.3%)). The ATV group had a higher proportion of more severe type II and III open fractures with 77.1% (n = 27), versus 56% (n = 35) in the non-ATV group (p = 0.020).. Revision and reoperation were more likely in the ATV group (16 (23%)) vs. the non-ATV group (12 (15%)), as was malunion (ATV group 3 (4.3%) Vs. non-ATV 0 (0%)).
CONCLUSION CONCLUSIONS
Open fractures resulting from ATV injuries tend to be more complex and have higher rates of revision and malunion. This information supports the large body of evidence on the dangers of ATVs to children and can help guide expectations of both clinicians and family members of patients presenting with these injuries.

Identifiants

pubmed: 36031440
pii: S0020-1383(22)00580-0
doi: 10.1016/j.injury.2022.08.023
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3322-3325

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Timothy W Torrez, James Hicks, Henry Bonner, Alexandra H Seidenstein, Ezan A Kothari, Gerald McGwin, and Shawn R Gilbert declare that they have no conflicts of interest.

Auteurs

Timothy W Torrez (TW)

University of California Los Angeles, David Geffen School of Medicine, CA, USA; University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Jimmy Hicks (J)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Vincent Bonner (V)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Alexandra H Seidenstein (AH)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Gerald McGwin (G)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Ezan Kothari (E)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA.

Shawn R Gilbert (SR)

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA. Electronic address: srgilbert@uabmc.edu.

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Classifications MeSH