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Factors Associated with Radiologic Tests in Patients with Radial Head Subluxation
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ÀåÀÍ¿Ï(Chang Ik-Wan) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
±èµµ±Õ(Kim Do-Kyun) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
¹Ú¼Ò¿µ(Park So-Young) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
¼µ¿¹ü(Suh Dong-Bum) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
Á¤ÀçÀ±(Jung Jae-Yun) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
°û¿µÈ£(Kwak Young-Ho) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
Abstract
Purpose: In general, X-ray examinations are not recommended for radial head subluxation (pulled elbow) patients. The purpose of this study was to determine the frequency of X-ray examinations and to investigate the factors associated with the decision to perform an X-ray examination on a patient with a pulled elbow.
Methods: Patients who visited the pediatric emergency department (ED) of one tertiary hospital from January 1, 2011, to December 31, 2012, with a diagnosis of radial head subluxation at discharge were enrolled in this study. Through retrospective chart reviews, factors that could have influenced the decision to perform an X-ray examination and their statistical relevance were analyzed.
Results: A total 308 patients were enrolled, and 101 patients (32.8%) underwent X-ray examinations. Among the 252 patients with a typical pulled elbow, 65 underwent X-ray examination. This result showed statistical significance compared to atypical pull-elbow group (25.8% vs. 64.3%, p<0.001). Factors associated with the decision to perform an X-ray examination were analyzed using the Chi-square test and the Fisher¡¯s exact test. The mechanism of injury and consultation with an orthopedic surgeon (p=0.001) showed statistical significance. In the multivariable logistic regression, the odds ratio (OR) for the injury mechanism was 4.7 (95% CI: 1.8~8.8, p<0.001) and that for consultation with an orthopedic surgeon was 8.0 (95% CI: 1.6~40.7, p=0.004).
Conclusion: One third of patients with a pulled elbow underwent X-ray examination, and patients with an atypical mechanism of injury underwent more frequent X-ray examinations than did patients with a typical mechanism of injury. The factors that could have influenced the decision to perform an X-ray examination were mechanism of injury and consultation with an orthopedic surgeon.
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Radius, X-ray, Child
KMID :
0360720140270020013
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