Related Experiment Video
Updated: Aug 7, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Assessing the risks of children with preoperative comorbidities undergoing comminuted fracture surgery
Kai-Yuan Cheng1, Chen-Yu Yang1, Shih-Chia Liu1
1Department of Orthopedics, MacKay Memorial Hospital, Taipei, Taiwan.
Insights
Comorbidities in pediatric patients with comminuted fractures are linked to longer hospital stays and more frequent discharges to long-term care. This finding aids in evaluating and managing these complex fractures in children.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Health Services Research
Background:
- Comminuted fractures, characterized by bones broken in multiple pieces, pose significant risks, especially in children due to their developing skeletal structure.
- Trauma is a leading cause of mortality in children, with orthopedic injuries presenting unique challenges compared to adults.
- Understanding factors influencing outcomes in pediatric comminuted fractures is crucial for effective management.
Purpose of the Study:
- To investigate the association between comorbid diseases and outcomes in pediatric patients undergoing surgery for comminuted fractures.
- To analyze the impact of comorbidities on length of stay (LOS) and discharge disposition.
- To refine the understanding of risk factors in pediatric comminuted fracture management.
Main Methods:
- Retrospective, cross-sectional study utilizing data from the National Inpatient Sample (NIS) database (2005-2018).
- Inclusion of pediatric patients (under 18 years) who underwent surgery for comminuted fractures.
- Logistic regression analysis to assess associations between comorbidities, surgical intervention, LOS, and discharge outcomes.
Main Results:
- A cohort of 101,032 pediatric patients with comminuted fractures who underwent surgery was analyzed.
- Patients with any comorbidities experienced significantly longer LOS and a higher likelihood of discharge to long-term care facilities.
- Nearly all analyzed comorbidities demonstrated a significant association with adverse in-hospital outcomes and extended LOS.
Conclusions:
- Comorbidities significantly impact in-hospital outcomes and resource utilization in pediatric patients with comminuted fractures.
- The findings underscore the importance of considering comorbidities in the evaluation and management strategies for pediatric comminuted fractures.
- This research provides valuable insights for healthcare providers involved in the care of pediatric trauma patients with complex fractures.
Introduction:
Comminuted fractures are characterized by bones broken in at least two places, destabilizing the bone and requiring surgery. Children whose bones are still developing and maturing tend to have a higher risk of sustaining comminuted fractures as the result of trauma. Trauma is a major cause of death in children and constitutes a major issue in orthopedics because of the unique properties of children's bones compared to adult bones and the associated complications.
Methods:
This retrospective, cross-sectional study aimed to refine the association between comorbid disease and comminuted fractures in pediatric subjects using a large, national database. All data were extracted from the National Inpatient Sample (NIS) database from 2005 to 2018. Logistic regression analysis was used to evaluate associations between comorbidities and comminuted fracture surgery and between various comorbidities and LOS or unfavorable discharge.
Results:
A total of 2,356,483 patients diagnosed with comminuted fractures were selected initially, of whom 101,032 patients aged younger than 18 years who underwent surgery for comminuted fractures were included. Study results suggest that patients with any comorbidities undergoing orthopedic surgery for comminuted fracture appear to have longer LOS and a higher proportion of discharge to long-term care facilities.
Discussion:
Almost all comorbidities were significantly associated with poor in-hospital outcomes and longer LOS. The analysis of comminuted fractures in children may provide useful information to help first responders and medical personnel evaluate and manage comminuted fractures appropriately.
More Related Videos
04:00Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
15:11Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
Published on: January 5, 2015
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:22Aneurysm IV: Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:28Cardiac Catheterization I: Pre-Procedure Overview