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Risk factors and nursing interventions for non-traumatic fractures in neonates and children: a systematic review with

Shannon Cresham Fox1, Takawira Marufu1, Rachel Boardman2

  • 1Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England.

Nursing Children and Young People
|February 23, 2026
PubMed

Insights

Non-traumatic fractures in children are complex. Key risk factors include prematurity, comorbidities, medicines, and nutrition, with nurses playing a vital role in prevention and care.

Area of Science:

  • Pediatrics
  • Nursing Science
  • Neonatal Care

Background:

  • Non-traumatic fractures in neonates and children present diagnostic challenges.
  • Nurses are crucial for early recognition, prevention, and safe care.
  • Existing evidence on risk factors and nursing management is limited.

Purpose of the Study:

  • To synthesize evidence on risk factors for non-traumatic fractures in neonates and children.
  • To review nursing management interventions for mitigating risk and improving outcomes.

Main Methods:

  • Systematic review of nine studies.
  • Content analysis and narrative synthesis of risk factors.
  • Analysis of two quality improvement (QI) projects in neonatal intensive care units.

Main Results:

  • Identified four main risk factor themes: prematurity/low birthweight, comorbidities, medicines, and nutrition.
  • Additional influences include sex and maternal characteristics.
  • QI projects showed multidisciplinary screening, nutritional optimization, staff education, and 'handle with care' signage reduced fracture rates.

Conclusions:

  • Non-traumatic fracture risk in neonates and children is multifactorial.
  • Nursing evidence is concentrated in neonatal settings.
  • Nurse-led screening and prevention protocols require further research.

Keywords:
babieschild healthclinical skillsevidence-based practiceinfantsneonatalnursing careresearchsystematic review

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