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Clinical Characteristics and Outcomes of Limb Fractures in Saudi Children
Lamia Aldhbiban1,2,3, Fai Alhoshan4,2,3, Raghad Alomari1,2,3
1Department of Pediatrics, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, Ministry of National Guard, Riyadh, SAU.
Insights
Motor vehicle accidents and falls are common causes of pediatric fractures. These injuries, along with sports-related incidents, are linked to longer healing times in children.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Public Health
Background:
- Pediatric fractures present unique clinical characteristics compared to adults.
- Understanding fractures in healthy children is crucial for identifying fragility fractures.
- This study focuses on Saudi children presenting to an emergency room.
Purpose of the Study:
- To evaluate clinical characteristics of limb fractures in healthy Saudi children.
- To identify clinical indicators of fracture healing outcomes.
- To analyze factors influencing fracture healing duration.
Main Methods:
- Retrospective review of pediatric fracture cases at King Abdullah Specialist Children's Hospital (KASCH) from 2016-2018.
- Exclusion of children with primary bone disorders or chronic comorbidities.
- Analysis of fracture mechanisms, sites, types, and healing times.
Main Results:
- 143 patients (mean age 8.23 years, 71% male) with 178 fractures.
- Motor vehicle accidents (35%) and falls (31.4%) were leading injury mechanisms.
- Femur (42.1%) and forearm (24.7%) fractures were most common; transverse fractures predominated (54%).
- Vitamin D deficiency was prevalent (71.7% of tested).
- MVAs and sports injuries, along with femur/forearm fractures, correlated with longer healing times (p < 0.001).
- Age, gender, and vitamin D status did not significantly impact healing duration.
Conclusions:
- MVAs and fall injuries are primary causes of pediatric fractures in the region.
- Injury mechanism (MVAs, sports) and fracture site (femur, forearm) significantly influence healing duration.
- Further large-scale prospective studies are recommended to explore clinical characteristics, outcomes, and environmental factors.
Background:
Children's bones are at high risk of fracture as they grow. The clinical characteristics of fractures in children differ from those in adults. Studying fractures in healthy children is critical for identifying cases of fragility fractures. The aim of this study was to assess the clinical characteristics of limb fractures as well as clinical indicators of fracture healing outcomes in healthy Saudi children seen in an emergency room.
Methods:
A retrospective review of the treatment course of all pediatric fractures and related factors treated at King Abdullah Specialist Children's Hospital (KASCH) in Riyadh between 2016 and 2018 was conducted. Children with a primary bone disorder or chronic comorbidities known to affect bone health were excluded.
Results:
The study included 143 patients (mean age ± SD = 8.23 + 3.76 years), and 71% (n = 102) were males. Motor vehicle accidents (MVAs) were the most common mechanism of injury, accounting for 50 (35%) cases, followed by fall injuries, sports injuries, and pedestrian accidents at 45 (31.4%), 16 (11.2%), and 13 (9.1%), respectively. A total of 178 fractures were reported, with the femur (n = 75, 42.1%) being the most common of the reported fracture sites, followed by the forearm (n = 44, 24.7%). The most common type of fracture was transverse fracture (n = 96, 54% of patients). Vitamin D levels were measured in 53/143 cases. Of these, vitamin D deficiency was found in 38 (71.7%) patients. The average time for fracture healing was 32.9 ± 30.2 weeks. The mechanisms of injury, including MVAs and sports injuries, as well as femur and forearm fractures, were clinical factors that were independently associated with a longer duration of fracture healing time (p < 0.001), but age, gender, and vitamin D status were not associated with that outcome.
Conclusion:
MVAs and fall injuries were the most common causes of fracture in our patients. MVAs and sports injuries were associated with prolonged healing time. Large prospective, multicenter, or field studies may be required to further explore clinical characteristics, outcomes, and environmental factors.
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