Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study

BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractures.AIM To evaluate the epidemiology of pediatric distal humerus fractures(SC,LC,and ME)from an American insurance claims database.METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC,LC and ME fractures based on the IBM Truven MarketScan®Commercial and IBM Truven MarketScan Medicare Supplemental databases.Patients from 2015 to 2020 were queried for treatments,patient age,sex,length of hospitalization,and comorbidities.RESULTS A total of 1133 SC,154 LC,and 124 ME fractures were identified.SC fractures had the highest percentage of operation at 83%,followed by LC(78%)and ME fractures(41%).Male patients were,on average,older than female patients for both SC and ME fractures.CONCLUSION In the insurance claims databases used,SC fractures were the most reported,followed by LC fractures,and finally ME fractures.Age was identified to be a factor for how a pediatric distal humerus fractures,with patients with SC and LC fractures being younger than those with ME fractures.The peak age per injury per sex was similar to reported historic central tendencies,despite reported trends for younger physiologic development.

Maxillofacial trauma in a pregnant patient:Contemporary management principles with a case report&review of literature

Trauma during pregnancy deserves special attention because of its management objectives,i.e.well-being of both pregnant woman and foetus.Maxillofacial trauma directly affects the nutrition of foetus by interfering with the normal functions in a pregnant woman such as mouth opening.mastication and breathing,Hence early restitution of form and function of maxillofacial skeleton is essential.However,the gravid status is associated with numerous anatomical and physiological changes which present with clinical dilemma related to imaging and treatment.A careful scrutiny of the patient's systermic and gestational status is absolutely essential before,during and after instituting any interventional proced-ures.We present a case of bilateral condyle fracture in a 30-year-old pregnant woman in the third trimester(32 weeks).She was treated with inter maxillary fixation using orthodontic brackets&elastics.After successful restitution of occlusion,the patient was advised aggressive physiotherapy which ensured normal mouth opening.Two weeks later,the patient delivered uneventfully.The patient was followed up at one month and 3 month and demonstrated restitution of normal occlusion,mouth opening and lower|acial height.This article aims at analyzing the contermporary principles in management of maxillfacial trauma in a pregnant woman and clarifying the common misconceptions.