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Journal of Children's Orthopaedics

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Open Access 01-08-2015 | Original Clinical Article

Risk factors for complications and readmission after operative fixation of pediatric femur fractures

Authors: Amit Momaya, Dustin Baker, Shawn Gilbert, Brent Ponce

Published in: Journal of Children's Orthopaedics | Issue 4/2015

Abstract

Purpose

Operative fixation of pediatric femur fractures with intramedullary implants has grown in popularity in recent decades. However, risk factors for short-term adverse events and readmission have not been well studied.

Methods

Pediatric patients who underwent intramedullary nailing of a femur fracture between 2012 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Risk factors for any adverse event (AAE) and readmission after intramedullary nailing were evaluated using univariate and multivariate analysis.

Results

A total of 522 pediatric patients who underwent intramedullary nailing of the femur during the study period were identified. The mean age of this patient cohort was 10.2 ± 3.8 years. Review of the cases revealed that 18 (3.4 %) patients had AAE and that 20 (3.8 %) patients were readmitted, of whom 13 (2.5 %) underwent a reoperation. Independent risk factors for AAE were a cardiac comorbidity [odds ratio (OR) 12.7, 95 % confidence interval (CI) 1.5, 103.7], open fracture (OR 10.2, 95 % CI 1.4, 74.4), and prolonged operative time (OR 17.5, 95 % CI 6.1, 50.5). Independent risk factors for readmission were a central nervous system disorder (OR 4.5, 95 % CI 1.3, 16.2) and a seizure disorder (OR 4.9, 95 % CI 1.0, 23.5).

Conclusions

The results of the multivariate analysis suggest that cardiac comorbidities, open fractures, and prolonged operative time increase the risk for AAE and that central nervous system disorders and seizure disorders may increase the risk for readmission. Surgeons should be aware of these risk factors and counsel the families of pediatric patients who undergo intramedullary nailing of femur fractures.

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Title: Risk factors for complications and readmission after operative fixation of pediatric femur fractures
Authors: Amit Momaya
Dustin Baker
Shawn Gilbert
Brent Ponce
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: Journal of Children's Orthopaedics / Issue 4/2015
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-015-0672-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Risk factors for complications and readmission after operative fixation of pediatric femur fractures

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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