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Primary Care Physician Follow-up of Distal Radius Buckle Fractures

Eric Koelink1, Suzanne Schuh2, Andrew Howard3

  • 1Division of Emergency Medicine, Department of Pediatrics, McMaster University Medical Centre and McMaster University, Hamilton, Ontario, Canada;

Pediatrics
|January 6, 2016
PubMed

Insights

Most children with buckle fractures followed PCP recommendations. Almost all children returned to normal activities within 4 weeks, despite limited guidance on activity return.

Area of Science:

  • Pediatric Orthopedics
  • Primary Care Medicine
  • Emergency Medicine

Background:

  • Distal radius buckle fractures are common pediatric injuries.
  • Follow-up care strategies aim to ensure appropriate healing and return to activity.
  • Primary care providers (PCPs) are often involved in the management of these fractures.

Purpose of the Study:

  • To determine the proportion of children with distal radius buckle fractures who adhered to PCP follow-up recommendations.
  • To assess the rate of exclusive PCP follow-up after emergency department (ED) referral.
  • To evaluate the provision of anticipatory guidance and return to usual activities within 4 weeks.

Main Methods:

  • Prospective cohort study in a pediatric ED.
  • Enrolled 200 children (aged 2-17 years) with distal radius buckle fractures treated with removable splints.
  • Assessed PCP follow-up, anticipatory guidance, and return to activities via telephone at 28 days.

Main Results:

  • 180 children (90.0%) were contacted; 157 (87.2%) received exclusive PCP follow-up.
  • Only 47.0% of those with a PCP visit received anticipatory guidance on return to activities.
  • 98.8% of children reported a full return to usual activities within 4 weeks.

Conclusions:

  • The majority of children with distal radius buckle fractures successfully followed the recommended PCP reassessment strategy.
  • While adherence to PCP follow-up was high, anticipatory guidance on activity return was suboptimal.
  • Nearly all children experienced a full return to usual activities, regardless of specific guidance received.
Abstract

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