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The single visit treatment of pediatric distal radius buckle fractures-A center's experience with the treatment
Chin Yee Woo1, Pak Leung Kenneth Wong1, Arjandas Mahadev1
1Department of Orthopedic Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore.
Insights
A single visit treatment protocol for pediatric distal radius buckle fractures is effective and recommended. This approach offers convenience, cost savings, and reduced labor, proving beneficial for patients and healthcare providers.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Pediatric distal radius buckle fractures are common injuries.
- Traditional management may involve multiple clinic visits and radiographic examinations.
- A single visit treatment protocol was implemented to streamline care.
Purpose of the Study:
- To evaluate the success, learning points, and limitations of a single visit treatment protocol for pediatric distal radius buckle fractures.
- To assess the efficacy and benefits of the protocol to encourage its wider adoption.
Main Methods:
- A retrospective review of clinical records for patients diagnosed with distal radius buckle fractures was conducted over two years post-implementation of a pilot study.
- Data included patient demographics, treatment protocol enrollment, number of clinic visits, radiographic examinations, complications, and treatment costs.
- Records were reviewed for up to three months post-injury.
Main Results:
- Out of 286 eligible patients, 202 (70.6%) were managed with the single visit protocol, while 84 (29.4%) received conventional care.
- All 202 protocol-managed patients achieved fracture healing without complications.
- The single visit protocol resulted in cost savings of USD 110.67 for residents and USD 320.80 for non-residents.
Conclusions:
- Single visit treatment for pediatric distal radius buckle fractures is a recommended evidence-based approach.
- The protocol offers significant advantages including patient convenience, reduced healthcare costs, and decreased labor intensity.
- This approach is effective in managing pediatric distal radius buckle fractures without compromising patient outcomes.
Introduction:
This descriptive study aims to review and evaluate the implementation of a single visit treatment protocol for pediatric distal radius buckle fractures at our center - its success, learning points and limitations. It hopes to raise awareness of the efficacy of the protocol and its benefits to promote its utilization.
Methods:
Following a pilot study, the protocol was implemented from 1 March 2017. A retrospective review of clinical records over 2 years since implementation for patients with a new-visit diagnosis of "distal radius buckle fracture" was conducted. Data collected included age at time of injury, gender, side of injury, whether the patient was enrolled into the protocol, number of clinic visits, and number of radiographic examination(s) performed. Each record was reviewed up to 3 months post-injury to check for any complications or return visits. Costs of specific treatment interventions were also obtained from the hospital's finance department.
Results:
286 patients with buckle fractures of the distal radius eligible for enrolment into the single visit treatment protocol were identified. Of these, 202 patients (70.6%) were enrolled and managed with the protocol, while 84 patients (29.4%) were treated with conventional management. Of the 202 protocol-managed patients, all fractures healed without complications. Only 4 patients returned for additional clinic visits. Another 4 patients had additional X-rays taken on top of their initial injury film. A breakdown of expenses for treatment also showed cost savings of USD 110.67 and USD 320.80 for residents and non-residents respectively for single visit treatment.
Conclusion:
Single visit treatment of pediatric distal radius buckle fractures is recommended and supported by evidence, with advantages of convenience, cost reduction, and being less labor intensive.
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