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A 10-year study of the changes in the pattern and treatment of 6,493 fractures
Insights
Pediatric fractures in children under 16 show common patterns, with distal radius and humerus fractures being most frequent. Treatment has shifted towards less invasive methods like closed reduction and percutaneous pinning.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Epidemiology
Background:
- Pediatric fractures are common injuries in children.
- Understanding fracture patterns and treatment trends is crucial for effective management.
Purpose of the Study:
- To analyze the epidemiological characteristics and treatment trends of pediatric fractures over a 10-year period.
- To identify age-specific fracture patterns in children.
Main Methods:
- Retrospective analysis of 6,493 inpatient fractures in children under 16 years.
- Data collection over a 10-year period at a single center.
- Analysis of fracture types, locations, patient demographics, and treatment modalities.
Main Results:
- Distal radius (20.2%), supracondylar humerus (17.9%), forearm shaft (14.9%), and tibial shaft (11.9%) were the most common fractures.
- Age-specific patterns observed: supracondylar humerus fractures common in younger children (0-7 years), distal radius fractures in older children (8-16 years).
- Significant increase in closed reduction and percutaneous pinning rates for distal radius, supracondylar humerus, and forearm shaft fractures; decreased open reduction rates and hospital stays.
Conclusions:
- Pediatric fracture patterns remain relatively consistent, but treatment strategies have evolved towards less invasive techniques.
- The shift in treatment reflects advancements in orthopedic surgical techniques and a focus on reducing hospital stays.
Abstract:
A total of 6,493 fractures was studied from 6,389 children younger than 16 years admitted as inpatients to one center in a 10-year period. The boy-to-girl ratio increased from 1.4:1 in the infants to 4.9:1 in the adolescents. The most common fractures were the distal radius (20.2%), supracondylar fracture of the humerus (17.9%), forearm shaft (14.9%), and the tibial shaft (11.9%). A distinct age-specific fracture pattern also was found, with supracondylar fracture of the humerus being the most common fracture in the age 0- to 3-year (26.7%) and the 4- to 7-year (31.6%) groups and distal radius in the 8- to 11-year and the 12- to 16-year groups (24.3 and 25.7%, respectively). Although the overall pattern of the major fractures had not changed over the 10-year period, significant changes in the treatment pattern were observed. The closed-reduction and percutaneous pinning rates increased from 9.5 to 38.7% in fracture of the distal radius, 4.3 to 40% in the supracondylar humerus, and 1.8 to 22% in the forearm shaft. The changes in treatment pattern were also accompanied by a corresponding decrease in the open-reduction rate and hospital stay periods from <10% to 38% of patients being discharged within 1 day of admission in the 10-year period.