Background and Aims Fractures are one of the most common causes of emergency department visits in pediatric patients in the United States.1 Timely treatment of these injuries is essential as a delay in management can lead to long term functional impairment, and additional operative procedures.2 We sought to examine trends and identify factors that may be associated with operative management by utilizing a large national database.
Methods This study was approved by the institutional review board of the Hospital for Special surgery (IRB#2017–0169). Using Truven Health Marketscan 2015–2019, we identified patients under 21 years who were diagnosed with fracture at hand/wrist, foot/ankle, forearm, or lower leg level. The outcome was if patients received surgical treatments within 3 months of a fracture. A multivariable logistic regression model was created to identify risk factors for surgical treatment after fracture.
Results Among the 325,853 pediatric fracture cases we identified, 4.4% cases received surgical treatment within 3 months after first fracture diagnosis. Multivariate logistic regression showed that independent risk factors for surgical treatment after fracture diagnosis included older age, male gender, having 1 or more comorbidities, obesity, lower leg fracture, residence in North Central and South compared with Northeast, and lower household income. (Table 1)
Conclusions Our study demonstrates a number of demographic variables that are independently associated with the use of a surgical approach to repair pediatric fractures. The significance of a number of these findings could highlight the stark differences and disparities in fracture care for pediatric patients in the United States.
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