G29(P) The management of children diagnosed with an uncomplicated clavicle fracture : broad-arm sling and written self-care information versus broad-arm sling and hospital outpatient follow-up

Crowder, R.; Rowland, Andrew; Tan, S.; Handford, M.; Stuart, M.

Abstract

Background and objectives: In July 2013 the Paediatric Emergency Department (ED) of a UK District General Hospital seeing approximately 30000 children per year aged under 16 years in the ED, began managing children diagnosed with an uncomplicated (no skin compromise and no clinical neuro-vascular deficit) clavicle fracture with a broad-arm sling and written self-care information, rather than a broad-arm sling and hospital-based fracture clinic follow-up. All other children continued to be referred to the fracture clinic. This study assessed the impact of this change in practice.
Methods: A 15 month retrospective review of all children diagnosed with a clavicle fracture was conducted. Referrals to fracture clinic and the number of children re-attending the ED with complications related to the initial injury (for example pain or sling problem) were analysed. All children had a broad-arm sling applied.
Results: 91 children were diagnosed with a clavicle fracture, 59 (median 5/month) pre-change in practice and 32 (median 7/month) post-change. 64 (70%) were referred to the fracture clinic, (52 (88%) pre-change in practice and 12 (38%) post-change). The remainder were discharged with written self-care information. In the one month following initial attendance, 3 (5%) re-attended the ED pre-change in practice and 0 (0%) post-change.
Conclusions: Children with an uncomplicated clavicle fracture can be appropriately managed with a broad-arm sling and written self-care information, rather than by hospital fracture clinic follow-up. This more efficiently uses healthcare resources, reduces re-attendances during the month following initial injury and reduces social inconvenience for children and families.

Citation

Crowder, R., Rowland, A., Tan, S., Handford, M., & Stuart, M. (2014). G29(P) The management of children diagnosed with an uncomplicated clavicle fracture : broad-arm sling and written self-care information versus broad-arm sling and hospital outpatient follow-up. Archives of Disease in Childhood, 99(Suppl), A13-A13. https://doi.org/10.1136/archdischild-2014-306237.29

• Journal Article Type: Article
• Online Publication Date: Apr 7, 2014
• Publication Date: Apr 1, 2014
• Deposit Date: Apr 11, 2017
• Journal: Archives of Disease in Childhood
• Print ISSN: 0003-9888
• Publisher: BMJ Publishing Group
• Volume: 99
• Issue: Suppl
• Pages: A13-A13
• DOI: https://doi.org/10.1136/archdischild-2014-306237.29
• Publisher URL: https://doi.org/10.1136/archdischild-2014-306237.29
• Related Public URLs: http://adc.bmj.com/