Outcomes of Toddler's Fractures After Implementation of Comprehensive Care Management Protocol With Controlled Ankle (CAM) Boots
View abstract on PubMed
Summary
This summary is machine-generated.A new protocol using controlled ankle motion (CAM) boots for toddler's fractures (TF) reduced skin breakdown in internally managed patients. This approach also lowered treatment costs, though external facility management remains a challenge.
Area Of Science
- Pediatric Orthopedics
- Trauma Surgery
Background
- Toddler's fractures (TF) are stable tibia fractures in children aged 1-4 years.
- Skin breakdown is a common complication of traditional casting and splinting for TF.
- A new treatment algorithm was developed to address skin breakdown issues.
Purpose Of The Study
- To evaluate the outcomes of a new treatment protocol for TF.
- To specifically assess the impact of the protocol on the incidence of skin breakdown.
- To analyze cost-effectiveness and fracture healing rates.
Main Methods
- Implementation of a protocol involving controlled ankle motion (CAM) boots for immobilization.
- Education for emergency and urgent care teams on proper CAM boot use.
- Development of caregiver handouts emphasizing skin checks and boot removal.
- Retrospective chart review of 429 TF patients (358 pre-protocol, 71 post-protocol).
Main Results
- The post-protocol group showed significantly higher CAM boot utilization (93% vs. 32.4%).
- Overall skin breakdown rates were not significantly different (9.9% vs. 17%), but all post-protocol cases originated from outside facilities.
- Internally managed patients had significantly less skin breakdown post-protocol (0% vs. 44.3%).
- Average cost savings of $187 per encounter were observed.
Conclusions
- The CAM boot protocol effectively reduced skin breakdown in patients managed internally.
- Fracture healing rates were equivalent to traditional long leg casts (LLC).
- The protocol decreased healthcare costs for patients.
- Addressing skin breakdown in patients initially treated at outside facilities requires further intervention.