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Outcomes of proximal humerus fractures in children: a study protocol for a retrospective cohort study

Samuel Richard Abbot1,2, Susanna Proudman3,4, Kelly Hall4

  • 1Orthopaedics and Trauma, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia Samuel.Abbot@sa.gov.au.

BMJ Open
|September 14, 2022
PubMed

Insights

This study analyzes functional and quality-of-life outcomes for pediatric proximal humerus fractures (PHFs) to guide optimal management. Findings will inform treatment decisions for displaced PHFs in children.

Area of Science:

  • Orthopedic surgery
  • Pediatric traumatology
  • Clinical outcomes research

Background:

  • Proximal humerus fractures (PHFs) are rare in children, accounting for <3% of all pediatric fractures.
  • Management of severely displaced PHFs in pediatric patients remains controversial, particularly in older children.
  • Conservative treatment is accepted for minimally displaced PHFs, but optimal strategies for severe displacement require further investigation.

Purpose of the Study:

  • To analyze functional and quality-of-life outcomes in children with proximal humerus fractures.
  • To identify clinical variables associated with poorer outcomes in pediatric PHFs.
  • To inform optimal management strategies for pediatric proximal humerus fractures.

Main Methods:

  • Retrospective cohort study design.
  • Evaluation of patients diagnosed with pediatric PHF at the Women's and Children's Hospital (WCH).
  • Assessment of pain and quality-of-life using validated instruments (QuickDASH, SPADI, PODCI), alongside secondary outcomes like non-union, deformity, and complications. Multivariable logistic regression will identify predictors of worse outcomes.

Main Results:

  • Data collection from clinic appointments, medical records, and WCH radiology database.
  • Analysis of functional outcomes, pain levels, and quality of life.
  • Identification of factors correlating with adverse clinical outcomes in pediatric PHFs.

Conclusions:

  • The study aims to provide evidence-based recommendations for managing pediatric proximal humerus fractures.
  • Findings will contribute to optimizing treatment strategies for both minimally and severely displaced fractures.
  • Improved understanding of outcomes will enhance patient care and long-term functional recovery.
Abstract

Keywords:
ORTHOPAEDIC & TRAUMA SURGERYPaediatric orthopaedicsShoulderTrauma management

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