title: Transportation of pediatric femur fractures to a tertiary care center: a retrospective review.
abstract: BACKGROUND
  Pediatric femur fractures are common injuries presenting to tertiary care trauma centers. Transportation of these patients occurs most commonly via ambulance or flight. The purpose of this study is to evaluate whether mode of transportation affects time to surgery or hospital stay for pediatric patients with femur fractures.
  
  
  METHODS
  Utilizing a trauma registry we queried pediatric femur fractures between January 2001 and December 2009. Patient age, gender, mechanism of injury, month of injury, type of fracture, transportation, county of origin, time to operating room (TTOR), hospital length of stay (HLOS), and treatment received were identified and compared.
  
  
  RESULTS
  In total, 519 femur fractures were identified, 257 (49.5%) of which were isolated injuries. Flight transportation was utilized in 13.6 % (35 of 257) of these isolated fractures. Mean TTOR for flight patients was 29 hours, HLOS 3.2 days. For ambulance transportation mean TTOR was 41 hours, HLOS 3.2 days. Neither variable was statistically different between transportation groups (TTOR p > 0.50; HLOS p > 0.95). No statistical difference was seen in HLOS (p > 0.47) and TTOR (p > 0.71) for patients originating further distances from the hospital.
  
  
  CONCLUSIONS
  Transportation method and distance from the hospital did not affect the TTOR and HLOS for isolated pediatric femur fractures. The use of air transportation for this group of patients, many of whom are injured by relatively low energy mechanisms, may be excessively costly and does not accelerate treatment.
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: David
authors.initials: D
authors.lastname: Alexander
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Horstmann
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: Janet
authors.initials: J
authors.lastname: Walker
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: Vishwas
authors.initials: V
authors.lastname: Talwalkar
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: Henry
authors.initials: H
authors.lastname: Iwinski
authors.affiliation: Study Performed at the University of Kentucky Chandler Medical Center, Department of Orthopaedic Surgery and Sports Medicine.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Milbrandt
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014187:Transportation of Patients / Q000379:methods*