Open Fractures Beyond Long Bones: Rethinking Age-Dependent Injury Mechanisms and Anatomical Patterns in Pediatric
Britta Chocholka1,2, Lara Marie Bogensperger1,2, Vanessa Groß1,2
1University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Children (Basel, Switzerland)
|July 28, 2026
Summary
Pediatric open fractures show age-related injury patterns, with upper extremity injuries common in young children and craniofacial fractures increasing in adolescents. This highlights the need to consider all anatomical sites in pediatric open fractures.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Epidemiology
Background:
- Open fractures in children and adolescents have incompletely defined epidemiological characteristics.
- Existing research often focuses on long-bone injuries, neglecting a comprehensive anatomical overview.
- Understanding age-dependent patterns is crucial for effective management and prevention.
Purpose of the Study:
- To analyze age-dependent injury mechanisms in pediatric open fractures.
- To determine the anatomical distribution patterns of open fractures across different pediatric age groups.
- To provide a comprehensive epidemiological overview of pediatric open fractures.
Main Methods:
- Retrospective cohort study of pediatric open fractures (0-18 years) from 2002-2023.
- Analysis of demographic data, injury mechanisms, anatomical locations, treatments, and complications.
- Statistical analysis to identify age-dependent variations in injury patterns.
Main Results:
- Injury mechanisms varied significantly by age, shifting from falls in infants to sports/traffic/confrontation-related injuries in adolescents.
- Upper-extremity fractures were most common overall (50.1%), but craniofacial fractures increased with age, dominating in adolescents (57.7%).
- Finger and nasal fractures were the most frequent specific locations; 15.2% of patients experienced complications.
Conclusions:
- Pediatric open fractures exhibit distinct age-dependent epidemiological patterns.
- Upper-extremity injuries are more prevalent in younger children, while craniofacial injuries rise in adolescents.
- The significant incidence of craniofacial and distal extremity fractures necessitates a broader anatomical focus beyond long bones.
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