Value-Based Care for Pediatric Supracondylar Humerus Fractures

Document Type

Book Chapter

Publication Date

5-2026

Identifier

DOI: 10.1007/978-3-032-19570-8_5

Abstract

Value = outcomes/cost. Multiple methods of value-based care can be safely applied to the treatment of supracondylar humerus fractures in children. In many cases, costs are reduced, outcomes are maintained, and value improves. For example, closed reduction and percutaneous pinning can safely be performed with a semi-sterile technique with no antibiotics. In addition, instead of treating all displaced supracondylar fractures as emergencies at night, Gartland type IIB fractures can be scheduled for surgery in a same-day surgical unit a few days after the injury. Gartland type III and IV injuries without vascular compromise can be treated the next day in a trauma operating room. Use of postoperative opioids can be minimized by injecting the fracture site with bupivacaine during surgery. For many supracondylar fractures, postoperative care can be simplified to one postop visit at 3–4 weeks to remove the cast and pins without additional follow-up or radiographs. Postoperative physical therapy can be limited to the occasional case. These techniques can improve value.

Journal Title

Value in Pediatric Orthopaedics

First Page

47

Last Page

61

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