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Epidemiology of pediatric forearm fractures in Washington, DC
Leticia Manning Ryan1, Stephen J Teach, Kimberle Searcy
1Center for Clinical and Community Research, Children's National Medical Center, Washington, DC 20010, USA. lryan@cnmc.org
Insights
Pediatric forearm fractures are rising, with most caused by falls from playground equipment and minor trauma. Prevention should focus on playground safety and investigate factors like obesity.
Area of Science:
- Pediatric Orthopedics
- Epidemiology
- Public Health
Background:
- Pediatric forearm fractures cause significant morbidity and healthcare costs.
- The incidence of these fractures is increasing despite public health injury prevention efforts.
- Characterizing the epidemiology in urban settings is crucial for targeted interventions.
Purpose of the Study:
- To analyze the epidemiology of forearm fractures in children treated at an urban pediatric emergency department.
- To identify demographic, seasonal, and injury-related factors associated with pediatric forearm fractures.
Main Methods:
- Retrospective study of children aged 0-17 years treated for isolated forearm fractures.
- Data collected via chart review from 2003-2006 at Children's National Medical Center Emergency Department (ED).
- Exclusion criteria included bone mineralization disorders and repeat visits; descriptive and bivariate analyses were performed.
Main Results:
- Analysis of 929 patients revealed a majority were male (64%) and African American (80%).
- Mean age was 8.4 years; 24.1% had a weight-for-age percentile ≥95%.
- Most fractures occurred in spring, primarily from falls (83%), with "fall from monkey bars" (17%) and minor trauma (58%) being significant contributors.
Conclusions:
- Falls from playground equipment and minor trauma are primary causes of pediatric forearm fractures.
- Prevention strategies should prioritize playground safety measures.
- Further research is warranted to explore the role of obesity and bone health in fracture risk.
Background:
Pediatric forearm fractures result in substantial morbidity and costs. Despite the success of public health efforts in the prevention of other injuries, the incidence of pediatric forearm fractures is increasing. Our objective is to characterize the epidemiology of forearm fractures in Washington, DC, children evaluated in an urban pediatric emergency department (ED).
Methods:
This retrospective study includes Washington, DC, children, aged 0 years to 17 years, treated for an isolated forearm fracture in the Children's National Medical Center ED from 2003 to 2006. Patients with bone mineralization disorders and repeat ED visits for the same fracture event were excluded. Chart review was done to obtain demographic and clinical data. Descriptive epidemiologic and bivariate analyses were conducted.
Results:
This preliminary analysis included 929 patients. The majority of patients are male (64%) and African American (80%). The mean age (± standard deviation) is 8.4 years (±3.9). Weight-for-age percentile was ≥95% in 24.1% of cases. Most forearm fractures occurred during the spring season. The most common mechanism of injury was fall-related (83%) whereas direct trauma caused 10% of fractures. "Fall from monkey bars" was the specific mechanism of injury in 17% of all cases. The majority of forearm fractures (58%) resulted from minor trauma.
Conclusions:
Falls from monkey bars and minor trauma are implicated in the majority of childhood forearm fractures. The prevention strategies should target playground safety. Further research is needed to evaluate factors, including obesity and bone health, which may contribute to forearm fracture risk associated with minor trauma.
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