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The Burden of Paediatric Supracondylar Humeral Fractures Admitted Within a Health Region in New Zealand
Evangeline Liddicoat1, Sheena Moosa2, Alastair Smith2
1Department of General Surgery, Waikato Hospital, Hamilton, New Zealand.
Insights
Supracondylar humeral fractures (SCHF) are common in children aged 5-9 years in Aotearoa New Zealand. Prevention strategies targeting homes and schools are needed to reduce falls and healthcare costs.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Public Health
Background:
- Supracondylar humeral fractures (SCHF) are the most common pediatric elbow injuries, frequently requiring surgery.
- This study examines the incidence and outcomes of pediatric SCHF across all injury severities in Aotearoa New Zealand.
Purpose of the Study:
- To determine the incidence and outcomes of supracondylar humeral fractures in children (0-14 years) over a 10-year period.
- To analyze demographic, injury, and cost data associated with pediatric SCHF hospitalizations.
Main Methods:
- Retrospective analysis of the Te Manawa Taki (TMT) Trauma Registry from 2012-2022.
- Identification of pediatric SCHF cases (0-14 years) using ICD-10 codes.
- Analysis of demographic data, injury characteristics, and hospital costs.
Main Results:
- An incidence of 73.7/100,000 pediatric SCHF was recorded, with the highest rates in 5-9 year olds.
- Falls (91.7%) were the primary cause, often occurring at home (40.9%) or school (32.5%).
- Most patients had a 1-day hospital stay, over 75% underwent surgery, and total costs exceeded $9.8 million.
Conclusions:
- Pediatric SCHF is a significant public health concern in Aotearoa New Zealand, particularly for children aged 5-9.
- Targeted injury prevention interventions in homes and schools are crucial to minimize falls.
- Reducing SCHF incidence can lead to substantial savings in healthcare expenditures.
Introduction:
Supracondylar humeral fractures (SCHF) comprise the majority of all paediatric elbow injuries and most require surgical intervention. This study determines the incidence and outcomes of SCHF in children of all injury severities admitted to hospital over 10 years in a health region of Aotearoa New Zealand (AoNZ).
Materials And Methods:
Retrospective data from Te Manawa Taki (TMT) Trauma Registry was extracted for all paediatric trauma hospitalisations (aged 0-14 years) with SCHF from 1 January 2012 to 31 December 2022. Patients with SCHF were identified using the International Classification of Disease-10 primary cause codes. Demographic and injury characteristics with hospital costs were analysed.
Results:
Paediatric SCHF (n = 1563) incidence was 73.7/100 000 (CI 61.5-85.8). Majority (62.8%) were aged 5-9 years with an incidence rate of 131.5/100 000 (CI 104.2-158.8). They were 6.6 and 2.0 times more frequently hospitalised than 10-14 and 0-4 year olds. The most common place for injury was home (40.9%) followed by school, other institution and public administrative area (32.5%). Falls accounted for 91.7% of injuries with most (52.4%) occurring at a height of less than 1 m. The majority (76.2%) of patients spent 1 day in hospital and over three quarters had operative management. Estimated hospital costs were $9 842 587 total with an average cost of $6354 per admission. There was no significant difference in annual incidence over time.
Conclusion:
Paediatric SCHF is a significant issue in AoNZ, particularly in those aged 5-9 years. There is a clear need for injury prevention interventions in the home and school to minimise falls and reduce healthcare costs.
