The Utility of the Early Postoperative Follow-Up and Radiographs After Operative Treatment of Supracondylar Humerus Fractures in Children (1)

Acosta, A. M., Li, Y. J., Bompadre, V., Mortimer, A., Trask, M., & Steinman, S. E. (2019). The utility of the early postoperative follow-up and radiographs after treatment of supracondylar humerus fractures in children. Journal of Pediatric Orthopedics; 40(5), 218 – 222. https://pubmed.ncbi.nlm.nih.gov/31368922/

This article is a retrospective cohort study that aims to evaluate how useful the 1-week postoperative follow-up visit for pediatric supracondylar humerus fractures repair. The outcomes examined were time to initial follow up, change in treatment plan after 1-week post-op radiographs, complications, demographics, fracture type, pin number and configuration, reduction parameters, immobilization, time to pin removal, duration of casting, and clinical outcome.

            They included 412 patients and retrospectively sorted them into either Group 1 (1^st post-op visit and x-ray in 1 week, 2^nd visit/x-ray/pin removal in 3-4 weeks) or Group 2 (1^st post-op visit/x-ray/pin removal in 3-4 weeks) based on their post-op plan. 368 patients were in Group 1 and 44 were in Group 2. Overall, they found that there was no significant difference in patient outcome or change in post-op management regardless of whether they had the 1-week follow-up visit.

            I chose this article because it was very recently published, included a moderate number of participants, and addressed the case I presented. Additionally, the two groups were not significantly different in terms of demographics, fracture type, and other factors.  However, there were some limitations. For example, while 412 participants in this type of population and scenario is respectable, it is really much smaller than the desired sample size. Looking at the p-values reported in the article, however, it does not seem like a larger sample size would have made much of a difference because no values concerning patient outcome were remotely close to be trending toward significant. The researchers ultimately recommend that, unless the fracture stability remains in question following the operative repair, patients with stable fractures should follow up in 3-4 weeks instead of at both 1 and 3-4 weeks.