Description
In this presentation, Helen Chase discusses recent developments and key findings in pediatric upper limb orthopedic care. She begins by introducing herself and her background with the BJJ 360 editorial board. Moving into the core of her presentation, Chase emphasizes the impact of COVID-19 on recent practices and highlights the efficacy of soft casts for managing upper limb injuries in pediatric patients. She points out the overuse of X-rays and unnecessary surgeries, advocating for a more cautious approach to avoid growth arrest in children.
Chase discusses updated guidelines for treating supracondylar fractures, including the recommendation for intraoperative assessments of stability and the necessity for proper documentation of stability assessments. The presentation also touches on the importance of nerve exploration in cases of iatrogenic nerve palsy, underscoring the requirement for consultant oversight before discharge.
She reviews recent studies comparing the effectiveness of cross versus lateral K-wiring, indicating that while cross K-wires show slightly better stability, there's a higher incidence of nerve injuries associated with them. Functionally, outcomes were found to be comparable between the two methods, with some evidence suggesting lateral wiring might yield slightly better results. Chase encourages ongoing research to further clarify best practices in this area.
Furthermore, she addresses the current understanding of radiographic needs post-operatively for supracondylar fractures, presenting data that suggests follow-up X-rays may not significantly impact management decisions after initial splint removal.
Chase concludes by summarizing recent insights into the treatment of distal radial fractures and emphasizes the potential for successful conservative strategies, particularly for younger patients. The presentation ends with a Q&A segment, where attendees engage with Chase on specific clinical scenarios, emphasizing the need for internal evaluations and the decision-making process behind surgical interventions.