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Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012

A I Cruz1, J E Kleiner2, J A Gil2

  • 1Department of Orthopaedics, Division of Paediatric Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Hasbro Children's Hospital, Providence, Rhode Island, USA.

Journal of Children'S Orthopaedics
|May 1, 2018
PubMed

Insights

Surgical treatment for pediatric proximal humerus fractures increased from 2000 to 2012. Older age and higher injury severity were linked to more surgeries, while Medicaid and children

Area of Science:

  • Orthopedic Surgery
  • Pediatric Traumatology
  • Health Services Research

Background:

  • Paediatric proximal humerus fractures are common injuries in children.
  • Understanding trends in surgical management is crucial for resource allocation and treatment guidelines.
  • Previous studies have not comprehensively analyzed national trends in operative treatment for these fractures.

Purpose of the Study:

  • To estimate the temporal trends in the surgical treatment rate of paediatric proximal humerus fractures.
  • To identify factors associated with the utilization of surgical intervention for these injuries.
  • To analyze data from a large, publicly available national database for robust insights.

Main Methods:

  • Analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database (2000-2012).
  • Identification of proximal humerus fractures using ICD-9-CM diagnosis codes.
  • Surgical treatment identified via ICD-9-CM procedure codes; logistic regression used for analysis.

Main Results:

  • A total of 7520 paediatric proximal humerus fracture admissions were reviewed; 43.2% underwent surgery.
  • The surgical treatment rate increased from 39.3% in 2000 to 46.4% in 2012 (p < 0.001).
  • Older age, higher injury severity, non-children's hospital, and non-Medicaid status were associated with increased surgery rates.

Conclusions:

  • The rate of operative treatment for paediatric proximal humerus fractures significantly increased between 2000 and 2012.
  • Surgical intervention is independently associated with older patient age, higher injury severity, and specific insurance/hospital types.
  • Further research is warranted to establish evidence-based outcomes supporting operative treatment for these fractures.
Abstract

Keywords:
Traumachildshoulder

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