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Epidemiology of trauma-related paediatric limb fracture using a unique classification: A 10-year retrospective,
Toshifumi Hikichi1, Munetomo Takata2, Takeshi Horii3
1Department Orthopedics, Kanazawa University Hospital, Takara-machi 13-1, Kanazawa, Ishikawa 920-8641, Japan.
Insights
This study details paediatric trauma cases over 10 years, identifying common fractures and injury mechanisms. A new classification system helps understand injury causes, aiding prevention and parent education for childhood fractures.
Area of Science:
- Pediatric Orthopedics
- Trauma Epidemiology
- Injury Prevention
Background:
- Limited research exists on pediatric trauma epidemiology.
- A 10-year single-center study was conducted to describe pediatric trauma cases.
- The study aims to improve pediatric care through a unique classification system.
Purpose of the Study:
- To describe the epidemiology of pediatric trauma.
- To introduce and utilize a novel trauma energy classification system.
- To enhance understanding of injury mechanisms in children.
Main Methods:
- Retrospective analysis of 1379 pediatric trauma cases (2008-2017).
- Data extracted from a computerized medical record system, including fracture and epiphyseal injury diagnoses.
- A new trauma energy classification based on speed and height categorized 'falls/turnover' mechanisms.
Main Results:
- School-aged children (6-10 years) experienced the highest injury incidence (40%).
- Forearm fractures were most common, followed by humeral fractures.
- Sports, playground equipment, furniture, and bicycling were leading causes of falls/turnovers; L2 (low height, high speed) was the most frequent energy category.
Conclusions:
- A detailed epidemiological profile of pediatric fractures is presented.
- A new classification system aids in understanding injury mechanisms irrespective of a child's height.
- Paediatric fractures at low energy levels, influenced by age, activity, and sex, offer potential for universal prevention strategies and parent education.
Introduction:
Research regarding the epidemiology of paediatric trauma is limited. Using our unique classification, we describe paediatric trauma cases in a 10-year single-centre study to improve paediatric care.
Materials And Methods:
Data regarding all paediatric trauma cases were extracted using a computerised medical record system that detected fracture diagnosis and epiphyseal injury. Registry search identified cases from January 2008 to December 2017. Age, sex, type of fracture, and details of injury mechanism were analysed, and we categorised the 'falls/turnover' mechanism using a new trauma energy classification based on speed and height.
Results:
A total of 1379 cases (953 boys and 426 girls) were included. The highest number of injuries (553 cases, 40%) was seen in school children (aged 6 to 10 years). Forearm fracture occurred most frequently, followed by humeral fracture. The most frequent injury mechanism in falls/turnover (969 cases, 70%) was sports in 272 cases (28%), playground equipment in 179 cases (18%), furniture in 102 cases (11%), and bicycling in 87 cases (9%). We classified 956 cases of falls/turnover using our trauma energy classification scheme. Most cases (29%) were classified into the L2 category (low height and high speed), followed by the L1 category (low height and low speed) (p < 0.01). Subcategory analysis using the classification revealed that younger children were more likely to be injured by falling from high places because of their physique, whereas older children were more likely to be injured by a turnover from lower places and at higher speed.
Conclusion:
We describe the epidemiology of fractures in detail and present a new classification system, which may aid in understanding the injury mechanism independent of children's height. The fact that paediatric fractures occur at relatively low energy levels and are trended by age, activity, and sex, could be of potential universal use for their prevention and parent education.
