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Temporal variation in pediatric supracondylar humerus fractures requiring surgical intervention
Randall T Loder1, Emily Krodel, Kelly D'Amico
1Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN USA ; James Whitcomb Riley Children's Hospital, Room 4250, 705 Riley Hospital Drive, Indianapolis, IN 46202 USA.
Insights
Pediatric humerus fractures peak in summer, with higher incidence on weekdays and evenings. This suggests targeted prevention campaigns and optimized operating room scheduling are needed.
Area of Science:
- Orthopedic Surgery
- Pediatric Trauma
- Epidemiology
Background:
- Pediatric supracondylar humerus fractures are common, necessitating surgery and hospital admission, incurring significant healthcare costs.
- Limited data exist on the temporal patterns of these fractures, hindering resource allocation and prevention efforts.
- Understanding injury timing can inform public health strategies and healthcare management.
Purpose of the Study:
- To investigate the temporal characteristics (month, day of week, time of day) of pediatric supracondylar humerus fractures.
- To identify patterns that can guide resource allocation and prevention strategies for these injuries.
- To analyze seasonal and daily variations in fracture occurrence.
Main Methods:
- Retrospective review of 353 pediatric operative supracondylar humerus fractures over six years.
- Data extraction included date and time of injury, demographics, and laterality.
- Circular analysis, cosinor analysis, and probability distributions were used to analyze temporal variations.
Main Results:
- A statistically significant increase in fractures was observed during summer, peaking in early July.
- Fracture peaks occurred Thursday-Saturday from May-July and mid-week from September-October.
- Injuries were more frequent on weekdays, in the morning, and during school hours, with a peak occurrence at 1800 hours.
Conclusions:
- Increased pediatric supracondylar humerus fractures in spring/autumn warrant early spring fall prevention education campaigns.
- Seasonal and hourly injury data support the need for dedicated early morning operating rooms for timely surgical intervention.
- Targeted prevention and resource management can mitigate the impact of these common pediatric fractures.
Background:
Pediatric supracondylar humerus fractures commonly require surgical intervention and hospital admission, which is costly and consumes significant health care resources. There are few data regarding temporal characteristics (month, day and hour of injury) of this particular pediatric fracture. We wished to investigate the month, day of the week, and time of occurrence of these fractures to guide appropriate use of health care resources and prevention strategies.
Methods:
This study was a retrospective review of clinical records and radiographs of 353 children with operative supracondylar humerus fractures in a temperate climate region over 6 years. Date and time of injury and demographic data (gender, age, laterality) were extracted. Variation in month, weekday, and time of injury was analyzed using circular analysis, cosinor analysis, probability distributions and topographical distribution.
Results:
There was a statistically significant increase in the number of fractures during the summer with a peak in early July. When analyzing by month and day of the week, a peak was seen Thursday-Saturday during May-July and middle of the week September-October. Weekdays demonstrated a higher proportion of fractures occurring in the morning and at school. The injuries occurred in the am in 37 and the pm in 241; detailed data were known in 227 with 37 between 0000 and 1159, 51 between 1200 and 1559, and 139 between 1600 and 2359 h. The peak time of injury was 1800 h.
Conclusions:
The increase in supracondylar humerus fractures in the spring through autumn in temperate regions indicates that education campaigns reinforcing fall prevention and landing surfaces should be done in the early spring. The hourly data support the need for dedicated early morning operating rooms to care for these fractures.
Level Of Evidence:
Prevalence study, retrospective cohort, Level II .
