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Trends in Hand Call at a Level One Pediatric Hospital and County Hospital

Melissa Cullom MD, Raj Chowdhury MD, Nikhi Paul Singh MD, MBA, William Wooden MD
Indiana University
2023-01-31

Presenter: Melissa Cullom MD

Affidavit:
All work on this project is the original work of the resident.

Director Name: William Wooden MD

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand

Introduction:
Acute hand issues are some of the most common reasons for presentation to the emergency department. At most academic medical centers, plastic surgeons divide hand call with orthopedics departments. This study aims to review and characterize consults seen during plastic surgery hand call and the associated call burden for an integrated/independent plastic surgery residency program.
Methods:
IRB exemption was obtained. Hand call sign outs from a level one pediatric hospital and level one county hospital from July to December 2022 were reviewed. Data included patient demographic information, injuries, procedures performed, and estimated time per call. Shared hand call taken at Indiana University Methodist Hospital was not included. Chi squared tests determined significance.
Results:
Of the 116 days reviewed, 83 days contained at least one hand consult, with 181 consults total. Majority of patients were male (69%) with an average age of 24 years old. The most common presentation was for a hand fracture (75) followed by laceration/soft tissue injury (58) and infection (20). In total, 63 bedside procedures were performed with most being laceration repairs (37). Three patients required operating room intervention overnight. There were no differences in injury patterns when patients were stratified by age or sex.
Conclusions:
Plastic surgeons are frequently responsible for responding to acute hand issues while on call. Within our institutions, the most common reasons for presentation were for hand fractures, followed by lacerations/soft tissue injury, and infection. Bedside procedures are commonly performed, with the most common being laceration repairs.

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