Keywords
bone
infant
child
preschool
adolescent
closed fracture reduction
open fracture reduction
fracture fixation
How to Cite
Abstract
Introduction: It is important to know the demographic and clinical characteristics of fractures in children to improve prevention and treatment strategies in these patients. Objectives: To describe fractures in children and their epidemiological characteristics. Methodology: Cross-sectional study performed between January 2014 and December 2017. Patients under 18 years old with fractures who consulted to a hospital in Colombia were included. Demographic data, the location where the trauma occurred, fractured bones and type of treatment were included. Age and gender distribution were analyzed. Medical records were the source of information. Central tendency and dispersion measures were used to group the data. Incidence of fractures per 1000 children / year was calculated. This study received approval from the institution’s ethics committee. Results: There were 2436 children with fractures, 65.6% (n=1597) occurred in males. Most fractures were in children between 6-11 years old (40.7%, n=991), followed by 12-17 years old (36.4%, n=887) and finally by children under 6 years old (22.9%, n=558). For the group under 6 years, most fractures occurred in humerus (30.6%, n=171), followed by radius (29%, n=162) and clavicle (15.9%, n=89); between 6-11 years old it was in radius (45.2%, n=448), followed by humerus (18%, n=178) and ulna (16.6%, n=165); and between 12-17 years it was in radio (34.6%, n=307), followed by bones of the hand (22.7%, n=201) and bones of the foot (10.8%, n=96). Surgical treatment was required in 30.9% (n=752) of the patients. The incidence of fractures was 29.7/1000 children per year. Conclusions: Fractures in children occur more frequently in males. The fractured bones differ depending on the age group; however, radius fractures represent an important proportion in all groups. Most fractures in children are treated in a conservative manner.
References
2. Neira JA, Bosque L, Zengotita S. Informe estadístico sobre trauma. Buenos Aires: Gobierno de la ciudad de Buenos Aires, Sociedad Argentina de medicina y cirugía del trauma. 2000.
3. Iñon AE, Rocca Rivarola M, Herscovici C, Alessandria JC. Morbilidad de los accidentes en pacientes pediátricos y sus familias. Arch Argent Pediatr. 1993; 91(4): 202-210.
4. Jeddi M, Dabbaghmanesh MH, Kharmandar A, Ranjbar Omrani G, Bakhshayeshkaram M. Prevalence of fracture in healthy Iranian children aged 9-18 years and associated risk factors; a population based study. Bull Emerg Trauma. 2017; 5(1): 29-35.
5. Franco-Abreu G, Rodríguez CP. Los accidentes en los niños. Un estudio epidemiológico. Rev Mex Pediatr. 2000; 67(1): 9-11.
6. Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007; 38(8): 913-922. doi: https://doi.org/10.1016/j. injury.2007.01.036.
7. Thandrayen K, Norris SA, Micklesfield LK, Pettifor JM. Fracture patterns and bone mass in South African adolescent- Mother pairs: The birth to twenty cohort. Osteoporos Int. 2014;25(2):693–700. doi: https://doi.org/10.1007/s00198-013-2477-4.
8. Valerio G, Gallè F, Mancusi C, Di Onofrio V, Colaprieto M, Guida P, et al. Pattern of fractures across pediatric age groups: Analysis of individual and lifestyle factors. BMC Public Health. 2010; 10: 656. doi: https://doi.org/10.1186/1471-2458-10- 656.
9. Christoffersen T, Ahmed LA, Winther A, Nilsen OA, Furberg AS, Grimnes G, et al. Fracture incidence rates in Norwegian children, The Tromsø Study, Fit Futures. Arch Osteoporos. 2016; 11(1): 40. doi: https://doi.org/10.1007/s11657-016-0294-z.
10. Danseco ER, Miller TR, Spicer RS. Incidence and costs of 1987-1994 childhood injuries: demographic breakdowns. Pediatrics. 2000; 105(2): E27. doi: https://doi.org/10.1542/peds.105.2.e27.
11. Alomran AK, Bubshait DA, Sadat-Ali M. Epidemiology of pediatric fractures and dislocations: Analysis of in-patients. Bahrain Med Bull. 2012; 34(4).
12. Wegmann H, Orendi I, Singer G, Eberl R, Castellani C, Schalamon J, et al. The epidemiology of fractures in infants - Which accidents are preventable? Injury. 2016; 47(1): 188-191. doi: https://doi.org/10.1016/j. injury.2015.08.037.
13. Saw A, Fadzilah N, Nawar M, Chua YP. Pattern of Childhood Fractures in a developing country. Malaysian Orthop J. 2011; 5(1): 13-16. doi: https:// doi.org/10.5704/MOJ.1103.003.
14. De Pablos J, González P. Fracturas Infantiles: conceptos y principios. 2da edición. España: Global HELP, 2010: p.34.
15. Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology of fractures in children and adolescents: Increased incidence over the past decade: A population-based study from northern Sweden. Acta Orthop. 2010; 81(1): 148-153. doi: https://doi.org/10.3109/17453671003628780.
16. Mora FG, Gustavo F, Carriedo JM, Bustamante BB, Mejía LC, López A, et al. Fracturas más frecuentes en niños en el Hospital Regional General Ignacio Zaragoza del ISSSTE. Esp Méd Quir. 2012; 17(3): 175-178.
17. Deakin DE, Crosby J, Moran CG, Chell J. Childhood fractures requiring inpatient management. Injury. 2007; 38(11): 1241-1246. doi: https://doi. org/10.1016/j.injury.2007.05.023.
18. Mäyränpää M. Fractures in Children: epidemiology and associated bone health characteristics. Helsinki: University of Helsinki. 2012.
19. Mansoor K, Shahnawaz S, Ahmad A, Arif MM, Hamza M. Epidemiology of childhood fractures in the city of Karachi. J Ayub Med Coll Abbottabad. 2015; 27(3): 608-612.
20. Concha J, Gerstner J, Gallón L, Bárcenas, C. Patrón de fracturas en niños en el Hospital Universitario de Cali. Rev Col Or Tra. 1990; 4(3): 247-251.
21. Goulding A. Risk Factors for Fractures in normally active children and adolescents. Med Sport Sci. 2007; 51: 102-120. doi: https://doi. org/10.1159/000103007.
22. Yeh FJ, Grant AM, Williams SM, Goulding A. Children who experience their first fracture at a young age have high rates of fracture. 2006; 17(2): 267-272. doi: https://doi.org/10.1007/s00198-005-2009-y.
23. Helenius I, Lamberg TS, Kääriäinen S, Impinen A, Pakarinen MP. Operative treatment of fractures in children is increasing. A population-based study from Finland. J Bone Joint Surg Am. 2009; 91(11): 2612-2616. doi: https://doi.org/10.2106/ JBJS.H.01519.
24. Vega R, Piñeros DF, Amador JS. Descripción epidemiológica y evaluación de los desenlaces de interés de las fracturas del tercio superior del húmero en niños. Rev Fac Med. 2014; 62(3): 347-353. doi: https://doi.org/10.15446/revfacmed.v62n3.39486.
25. Riascos GA. Descripción epidemiológica de las fracturas de tibia y peroné en el Hospital de la Misericordia en los últimos 5 años. Tesis de grado: Universidad Nacional de Colombia. 2012.
26. Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl. 1983; 202: 1-109. doi: https://doi. org/10.3109/17453678309155630.
27. Mortensson W, Thönell S. Left-side dominance of upper extremity fracture in children. Acta Orthop Scand. 1991; 62(2): 154-155. doi: https://doi. org/10.3109/17453679108999245. Artículo de revista
28. Hassan FO. Hand dominance and gender in forearm fractures in children. Strategies Trauma Limb Reconstr. 2008; 3(3): 101-103. doi: https://doi. org/10.1007/s11751-008-0048-6.
29. Rohl L. On fractures through the radial condyle of the humerus in children. Acta Chir Scand. 1952; 104(1): 74-80.
30. Salunkhe RM, Deshmukh A, Kumar Sumeet, Kandari A. Conservative vs. surgical intervention in diaphyseal forearm fractures in age group 1 to 15 years: A prospective study. Int. j. orthop. sci. 2018; 4(3): 251-254. doi: https://doi.org/10.22271/ ortho.2018.v4.i3e.43.
31. Kinney MC, Nagle D, Bastrom T, Linn MS, Schwartz AK, Pennock AT. Operative versus conservative management of displaced tibial shaft fracture in adolescents. J Pediatr Orthop. 2016; 36(7): 661-666. doi: https://doi.org/10.1097/ BPO.0000000000000532.
32. Tisosky AJ, Werger MM, McPartland TG, Bowe JA. The Factors Influencing the refracture of pediatric forearms. J Pediatr Orthop. 2015; 35(7): 677-681. doi: https://doi.org/10.1097/BPO.0000000000000355.
This work is licensed under a Creative Commons Attribution 4.0 International License.