VCOM Research Day Program Book 2023

Medical Student Research Cl inical

06 Long Arm Splint Provides Equivalent Postoperative Immobilization to Long Arm Cast After Crpp Of Supracondylar Humberus Fracture

Michael McGehee; Elizabeth Duckworth; Christopher Souder; Matthew Ellington; Swati Iyer Corresponding author: mmcgehee@vt.vcom.edu

Edward Via College of Osteopathic Medicine – Virginia Campus; VCOM Sports and Osteopathic Medicine

fluoroscopy images and four week postoperative imaging for a random sample of 15 patients from the splint group and the long arm cast group. Loss of reduction was defined as >10° change in Baumann’s angle and lateral capitellar humeral angle. Bivariate analysis was conducted using SAS. Results: 595 patients were included in this study. 118 patients (20%) received immobilization in a splint. 4 patients underwent reoperation, all in the cast group. There was no significant difference in reoperation rate, infection, prescription of physical therapy, or loss of reduction between the two groups. The splint group patients attended an average of 2.4 clinic visits compared to 3.4 clinic visits for the cast group patients (P<0.001). Conclusions: Immobilization in a long arm splint after closed reduction percutaneous pinning of a displaced supracondylar humerus fracture did not lead to an increase in reoperation, infection, physical therapy, or loss of reduction. The long arm splint group needed significantly fewer postoperative clinic visits than the long arm cast group.

Introduction: Displaced supracondylar humerus fractures are commonly managed with closed reduction percutaneous pinning and a long arm valved fiberglass cast. Use of a fiberglass cast acutely necessitates an additional postoperative visit for an overwrap, incurring direct and indirect costs to the healthcare system and patient’s family. The objective of this study is to determine if a long arm splint provided equivalent post operative stabilization compared to a long arm cast. Methods: Retrospective chart review was performed of operatively managed displaced supracondylar humerus fractures treated by a single group in a four year period from June 1, 2018 to May 31, 2022. Patients were separated into a long arm splint cohort and a long arm fiberglass cast cohort. Polytrauma patients and those presenting more than two weeks after injury were excluded. Primary outcome measurement was reoperation. Secondary outcome measurements were: infection, prescription of physical therapy, loss of reduction, and number of postoperative clinic visits. Infection was determined by prescription of oral antibiotics. Loss of reduction was assessed by comparing the intraoperative

Significance: A long arm splint provided appropriate postoperative immobilization for displaced supracondylar humerus fractures while requiring fewer postoperative clinic visits, decreasing the postoperative burden on patients and their families.

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