Paediatrician office follow-up of common minor fractures |
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Authors: | Eric Koelink Kathy Boutis |
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Institution: | 1.Division of Emergency Medicine, Department of Pediatrics, McMaster University Medical Centre and McMaster University, Hamilton;;2.Division of Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario |
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Abstract: | BACKGROUND:Evidence suggests that minor paediatric fractures can be followed by primary care paediatricians (PCPs).OBJECTIVES:To determine PCP opinions, knowledge and perceived barriers to managing minor paediatric fractures in the office.METHODS:An online survey was sent between June and September 2013 to all paediatricians who subscribed to the American Academy of Pediatrics PROS-Net Listerv and to those who were registered with the Scott’s Canadian Medical Directory as paediatricians who treated children in a primary care capacity. The primary outcome was the proportion of PCPs who agreed with PCP follow-up of minor paediatric fractures. Secondary outcomes included PCP’s perceived barriers to office follow-up.RESULTS:A total of 1752 surveys were sent; 1235 were eligible and 459 (37.2%) responded to the survey. Overall, 296 (69.5% 95% CI 65.2% to 74.0%]) PCPs agreed that minor paediatric fractures could be followed in a PCP office. The most frequently reported barriers were lack of materials to replace immobilization (58.1%), PCP knowledge deficits (44.8%) and a perceived parental preference for an orthopedic surgeon (38.6%). Finally, 58.8% of respondents believed that further education was necessary if PCPs assumed responsibility for follow-up of midshaft clavicle fractures, while 66.5% and 77.1% (P<0.0001) believed this was necessary for distal radius buckle and fibular fractures, respectively.CONCLUSIONS:More than two-thirds of responding PCPs in Canada and the United States agreed that minor common paediatric fractures can be followed-up by paediatricians. However, PCPs reported some barriers to this management strategy, including a desire for more education on this topic. |
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Keywords: | Child Fractures Surveys |
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