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Original article
peer-reviewed

Improving Management of Paediatric Buckle Fracture in Orthopaedic Outpatients: A Completed Audit Loop



Abstract

Introduction

Paediatric patient bone fractures are the source of a large number of orthopaedic outpatient visits, especially for fracture clinics. The National Institute for Health and Care Excellence (NICE) guideline NG38 provides guidance on assessing and managing non-complex fractures, such as buckle (i.e., torus) fractures in paediatric patients.

Objective

We retrospectively audited outpatient records of children younger than 12 years presenting with distal radius buckle fractures for May and June 2017. We compared our practice against the NICE guideline standards. We made certain changes in our practice and then repeated the exercise prospectively for two months from July 15 to September 15, 2017.

Material and Methods

We identified 31 patients who fit our inclusion criteria. After instituting changes based on the NICE guidelines, the number of children included in the prospective data collection was 33 patients.

Results

For the 31 children treated according to our older protocol, we had 59 outpatient visits, with an average of 1.90 visits for every child. After the NICE-driven changes were made to our management, 33 patients were treated in 39 visits with an average of 1.2 visits per child.

Conclusion

Introducing NICE guidelines allowed for considerable improvement in the management and treatment of paediatric patient bone fractures. It is important to fully implement the NICE guidelines not only in fracture clinics but also in other departments, such as accident and emergency departments.



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Original article
peer-reviewed

Improving Management of Paediatric Buckle Fracture in Orthopaedic Outpatients: A Completed Audit Loop


Author Information

MN Baig Corresponding Author

Orthopaedics, Galway University Hospital

C Egan

Trauma & Orthopaedics, Galway Univers


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Original article
peer-reviewed

Improving Management of Paediatric Buckle Fracture in Orthopaedic Outpatients: A Completed Audit Loop


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Original article
peer-reviewed

Improving Management of Paediatric Buckle Fracture in Orthopaedic Outpatients: A Completed Audit Loop

MN Baig">MN Baig , C Egan">C Egan

  • Author Information
    MN Baig Corresponding Author

    Orthopaedics, Galway University Hospital

    C Egan

    Trauma & Orthopaedics, Galway Univers


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: November 08, 2017

    DOI

    10.7759/cureus.1829

    Cite this article as:

    Baig M, Egan C (November 08, 2017) Improving Management of Paediatric Buckle Fracture in Orthopaedic Outpatients: A Completed Audit Loop . Cureus 9(11): e1829. doi:10.7759/cureus.1829

    Publication history

    Received by Cureus: September 29, 2017
    Peer review began: November 03, 2017
    Peer review concluded: November 04, 2017
    Published: November 08, 2017

    Copyright

    © Copyright 2017
    Baig et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

Paediatric patient bone fractures are the source of a large number of orthopaedic outpatient visits, especially for fracture clinics. The National Institute for Health and Care Excellence (NICE) guideline NG38 provides guidance on assessing and managing non-complex fractures, such as buckle (i.e., torus) fractures in paediatric patients.

Objective

We retrospectively audited outpatient records of children younger than 12 years presenting with distal radius buckle fractures for May and June 2017. We compared our practice against the NICE guideline standards. We made certain changes in our practice and then repeated the exercise prospectively for two months from July 15 to September 15, 2017.

Material and Methods

We identified 31 patients who fit our inclusion criteria. After instituting changes based on the NICE guidelines, the number of children included in the prospective data collection was 33 patients.

Results

For the 31 children treated according to our older protocol, we had 59 outpatient visits, with an average of 1.90 visits for every child. After the NICE-driven changes were made to our management, 33 patients were treated in 39 visits with an average of 1.2 visits per child.

Conclusion

Introducing NICE guidelines allowed for considerable improvement in the management and treatment of paediatric patient bone fractures. It is important to fully implement the NICE guidelines not only in fracture clinics but also in other departments, such as accident and emergency departments.



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Create a free account to continue reading this article.

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MN Baig

Orthopaedics, Galway University Hospital

For correspondence:
nouman142@gmail.com

C Egan

Trauma & Orthopaedics, Galway Univers

MN Baig

Orthopaedics, Galway University Hospital

For correspondence:
nouman142@gmail.com

C Egan

Trauma & Orthopaedics, Galway Univers