Nonoperative management of pediatric grade 1 open fractures with less than a 24-hour admission
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1Department of Orthopaedics, State University of New York at Buffalo, Buffalo, NY, USA.
Insights
Nonoperative management of pediatric grade 1 open fractures is safe and effective. This approach reduces healthcare costs and avoids anesthetic risks for young patients.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Evidence-Based Medicine
Background:
- Pediatric open fractures require careful management to prevent infection and ensure proper healing.
- Traditional treatment may involve surgical intervention, carrying risks and higher costs.
Purpose of the Study:
- To evaluate the outcomes of nonoperative management for pediatric grade 1 open fractures.
- To assess the safety and efficacy of emergency room-only or short-term admission treatment protocols.
Main Methods:
- Retrospective chart review of 25 pediatric patients with grade 1 open fractures.
- Treatment involved nonoperative modalities, with admission for ≤24 hours for IV antibiotics.
- Patients were monitored until clinical and radiographic healing.
Main Results:
- A low infection rate of 4.0% was observed.
- One patient required extended antibiotic treatment for presumed infection but healed without complications.
- All patients achieved clinical and radiographic bone healing.
Conclusions:
- Nonoperative treatment is a safe and viable option for pediatric grade 1 open fractures.
- This management strategy minimizes anesthetic risks.
- It offers significant cost savings within the healthcare system.
Background:
The purpose of this study was to evaluate the results of nonoperative management of pediatric grade 1 open fractures treated either in the emergency room only or with a less than 24-hour admission.
Methods:
A retrospective chart review was done on all patients with this type of injury who were treated by nonoperative modalities in the emergency room and who were admitted for no more than 24 hours for administration of intravenously administered antibiotics. Our population included 25 patients who were followed up until healing was confirmed clinically and radiographically.
Results:
One patient with persistent serosanguineous drainage from the wound site and fever was admitted for 48 hours of intravenously administered antibiotics for presumed infection. That patient went on to heal both clinically and radiographically without further complication. Therefore, our infection rate was 4.0%.
Conclusions:
This study demonstrates the safe nonoperative treatment of grade 1 open fractures in our pediatric population. This management eliminates any possible anesthetic risk as well as significantly decreases the cost of caring for these patients in the health care system.
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