{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:36:56Z","timestamp":1790102216429,"version":"4.0.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed an analysis of patients between 1 and 14 years of age who presented to the emergency department (ED) with a forearm fracture requiring reduction. Data collected included reducing provider (PEM or orthopedist) and prereduction, postreduction, and follow-up fracture angles and displacements of both radius and ulna. We collected costs of care, both in the ED and at follow-up, as well as length-of-stay data. \u03c7<jats:sup>2<\/jats:sup> Tests and Fisher exact test compared associations between categorical variables; 2-sample <jats:italic toggle=\"yes\">t<\/jats:italic> tests compared the PEM and orthopedic groups. Regression models were used to control for injury severity confounders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 222 fractures, orthopedists reduced 135, and PEM doctors reduced 87. Based on fracture angle and displacement, the orthopedic group tended to have slightly more complicated cases. After adjusting for age and time to follow-up, fractures reduced by orthopedists were less likely to require remanipulation (adjusted odds ratio, 0.30; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.020). The PEM group had a significantly lower length of stay (59.4 minutes shorter; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) and a small overall saving in charges ($273.90; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.47).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Orthopedists performed better in maintaining fracture reductions compared with PEM physicians but lengthened the ED stay for our patients. There was no significant difference in cost.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001152","type":"journal-article","created":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T18:46:36Z","timestamp":1497984396000},"page":"451-456","source":"Crossref","is-referenced-by-count":10,"title":["Outcome of Pediatric Forearm Fracture Reductions Performed by Pediatric Emergency Medicine Providers Compared With Reductions Performed by Orthopedic Surgeons"],"prefix":"10.1097","volume":"34","author":[{"given":"Donna","family":"Milner","sequence":"first","affiliation":[{"name":"Emergency Department and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Krause","sequence":"additional","affiliation":[{"name":"Research and Sponsored Programs, Children\u2019s Hospitals and Clinics of Minnesota, St Paul, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Hamre","sequence":"additional","affiliation":[{"name":"Research and Sponsored Programs, Children\u2019s Hospitals and Clinics of Minnesota, St Paul, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Flood","sequence":"additional","affiliation":[{"name":"Research and Sponsored Programs, Children\u2019s Hospitals and Clinics of Minnesota, St Paul, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230930","first-page":"39","article-title":"The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population","volume":"25","year":"2005","journal-title":"J Pediatr Orthop"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1097\/BPO.0b013e3181558c4d","article-title":"Demographic and financial implications of pediatric emergency department fracture manipulation","volume":"27","year":"2007","journal-title":"J Pediatr Orthop"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1111\/j.1553-2712.2010.00917.x","article-title":"Closed reduction of distal forearm fractures by pediatric emergency physicians","volume":"17","year":"2010","journal-title":"Acad Emerg Med"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/BOT.0b013e3181bd5863","article-title":"A comparison of fracture reductions performed by physician extenders and orthopaedic residents in the acute pediatric orthopaedic practice","volume":"24","year":"2010","journal-title":"J Orthop Trauma"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jemermed.2008.08.030","article-title":"Pediatric distal radial fractures treated by emergency physicians","volume":"37","year":"2009","journal-title":"J Emerg 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conservatism","volume":"19","year":"1999","journal-title":"J Pediatr Orthop"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/01.bpo.0000158780.52849.39","article-title":"Cast immobilization versus percutaneous pin fixation of displaced distal radius fractures in children: a prospective, randomized study","volume":"25","year":"2005","journal-title":"J Pediatr Orthop"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201807000-00001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:09:38Z","timestamp":1696061378000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201807000-00001"}},"subtitle":["A Retrospective Cohort Study"],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001152","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}