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10:08
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
Refractures in Children
Oskari Pakarinen1,2, Matti Ahonen3, Petra Grahn3
1Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland.
The Journal of Bone and Joint Surgery. American Volume
|March 27, 2025
Summary
Pediatric refractures occur in about 0.5% of childhood fractures, most commonly in diaphyseal forearm fractures. Displaced fractures treated with closed reduction show a significantly higher risk of refracture.
Area of Science:
- Pediatric Orthopedics
- Pediatric Traumatology
- Pediatric Bone Health
Background:
- Refractures in children are a significant concern, yet data on their incidence and risk factors remain limited.
- Understanding refracture patterns is crucial for optimizing pediatric fracture management and patient outcomes.
Purpose of the Study:
- To determine the incidence of radiographically confirmed refractures within two years in pediatric patients.
- To analyze the association between fracture stability and the risk of refracture in children.
Main Methods:
- Retrospective review of pediatric patients (<16 years) with at least two fractures in the same bone (2014-2023).
- Exclusion of pathological fractures, systemic conditions predisposing to fractures, and fractures in different bone locations.
- Radiographic and clinical record evaluation to identify and analyze refractures.
Main Results:
- A total of 100 refractures (0.48% of all fractures) were identified from 20,749 initial fractures.
- Highest refracture rates observed in diaphyseal both-bone forearm (3.76%), diaphyseal tibial (1.01%), distal forearm (0.55%), and distal humeral (0.49%) fractures.
- Displaced fractures requiring closed reduction exhibited a significantly higher refracture risk (RR 8.0) compared to stable fractures.
Conclusions:
- The overall pediatric refracture rate is approximately 0.5%, with diaphyseal both-bone forearm fractures being most susceptible.
- Median time to refracture varies by anatomical location, with distal forearm fractures healing fastest.
- Fracture displacement and closed reduction treatment are significant risk factors for refracture in children.
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