Pediatric Hip Fractures in California: Results from a Community-Based Hip Fracture Registry
Heather A Prentice1, Elizabeth W Paxton2, Jessica J Hunt3
1Research Scientist I Investigator in Surgical Outcomes and Analysis for the Southern California Permanente Medical Group in San Diego. heather.prentice@kp.org.
Insights
Pediatric hip fractures are more common in boys and Hispanic patients, with intertrochanteric fractures being the most frequent type. Short-term complications following surgical treatment were infrequent in this study.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Public Health
Background:
- Hip fracture registries are valuable for monitoring rare conditions, including pediatric hip fractures.
- Understanding the demographics and outcomes of pediatric hip fractures is crucial for targeted interventions.
Purpose of the Study:
- To characterize patient demographics and surgical outcomes for pediatric hip fractures.
- To analyze fracture types, surgical treatments, and short-term complications in young patients.
Main Methods:
- Retrospective analysis of a hip fracture registry from 2009-2012.
- Inclusion of pediatric patients (<21 years) treated surgically for hip fractures.
- Data collection on patient characteristics, fracture type, surgical management, and complications.
Main Results:
- 39 pediatric patients (79.5% male, median age 15) were identified.
- Hispanic (43.6%) and white (35.9%) patients were most common; 20.5% had comorbidities.
- Intertrochanteric fractures (Delbet Type IV) were most common (56.4%); fixation methods were equally distributed.
- Short-term complications were infrequent: 7.7% readmissions, 2.6% infection, 2.6% malunion, 2.6% revision.
Conclusions:
- Pediatric hip fractures in this registry were more prevalent in males and Hispanic individuals.
- Intertrochanteric fractures (Delbet Type IV) were the most frequent type observed.
- Surgical treatment of pediatric hip fractures resulted in infrequent short-term complications.
Context:
Hip fracture registries offer an opportunity to identify and to monitor patients with rare conditions and outcomes, including hip fractures in pediatric patients.
Objective:
To report patient demographics and surgical outcomes of pediatric patients treated surgically for hip fractures in a large integrated health care system.
Design:
Pediatric patients (< 21 years old at the time of fracture) with hip fractures were identified between 2009 and 2012 using our health care system's hip fracture registry.
Main Outcome Measures:
Patient characteristics, type of fracture, surgical treatment, and short-term complications.
Results:
Among 39 patients identified, 31 (79.5%) were male, and the median age was 15 years old (interquartile range: 11-17 years). Most patients were Hispanic (n = 17, 43.6%) or white (n = 14, 35.9%). There were 8 patients (20.5%) with 15 comorbidities. Delbet Type IV (intertrochanteric) fractures were the most common fracture type (n = 22, 56.4%), and fixation method was equally distributed between intramedullary, screw and sideplate, and screws (n = 12, 30.8% for each). Most surgeries were performed by medium-volume surgeons (n = 22, 56.4%) at medium- and high-volume hospitals (n = 37, 94.9%). Three 90-day readmissions (7.7%), 1 infection (2.6%), 1 malunion (2.6%), and 1 revision (2.6%) were observed in this cohort during the study period.
Conclusion:
In our series using registry data, hip fractures younger than age 21 years were more common in boys and Hispanic patients. Intertrochanteric fractures (Delbet Type IV) were the most frequently observed type in our community-based hip fracture registry. Short-term complications were infrequent.
