[The frequency and distribution of fractures in children presenting to the emergency service]

We investigated the frequency and distribution of childhood fractures seen at the emergency service of Tepecik Education and Research Hospital, Izmir, Turkey.

This prospective study included fractures of 1,706 children (992 boys, 714 girls; age range 0 to 14 years) who presented to the emergency department on even-numbered days. Data forms including information about characteristics of the patients and fractures were filled in for each case. Age and sex of the patients, date and time of fractures together with mechanism, site, and type were recorded.

The most frequent ages for fractures were 7 (9%) and 3 (8%) years for boys, and 4 (9%) and 5 (8.5%) years for girls. The most common cause was domestic accidents (53%), followed by school (22%), traffic (17%), and sport (8%) accidents. Fractures occurred most frequently in summer (35%) especially in July, followed by autumn (24%), winter (21%), and spring (20%). The most frequent time intervals of presentation were between 16 and 20 hours (32%) and between 20 and 24 hours (25%). The most common site of involvement was the distal radius (26%), followed by the elbow (19%), forearm (17%), hand-foot (12%), clavicle (9%), tibia (7%), and the femur (6%). The humerus (1%) was the least affected site. Treatment included conservative methods in 84%, and surgical methods in 16%.

In our area, child fractures generally result from falls in summer and spring months and at play hours and are generally treated with conservative methods. Distal radius fractures are the most frequent and, inconsistent with the relevant literature data, occur at younger ages.