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Osteosynthesis and Trauma Care 2006; 14(1): 39-44
DOI: 10.1055/s-2006-921365
Original Article

© Georg Thieme Verlag Stuttgart · New York

Fractures of Long Bones in Children and Adolescents

R. Kraus1 , 7 , C. Ploss2 , L. Staub3 , J. Lieber4 , 7 , V. Alt1 , A. Weinberg5 , 7 , A. Worel6 , 7 , D. Schneidmüller , 7 , C. Röder3
  • 1Department of Trauma Surgery, Justus Liebig University, Gießen, Germany
  • 2Department of Trauma Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
  • 3Institute of Evaluative Research in Orthopaedic Surgery, University of Berne, Switzerland
  • 4Department of Children's Surgery, Hospital St. Hedwig, Regensburg, Germany
  • 5Department of Children's Surgery, Karl Franzens University, Graz, Austria
  • 6Department of Children's Surgery, Hospital Centre, Biel, Switzerland
  • 7“Li-La” - Licht und Lachen für kranke Kinder, Effizienz in der Medizin e. V., Basel, Switzerland
Further Information

Publication History

Publication Date:
02 March 2006 (online)

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Abstract

Competent treatment of fractures in adolescents includes specific knowledge about the incidence, age distribution and causes of these fractures. The current study reports about a multi-centre epidemiological investigation on 682 long bone fractures in children and adolescents involving 13 hospitals in Germany, Austria and Switzerland. The fractures were classified according to the “Li-La” classification, introduced von Laer and co-workers [19]. This classification uniquely takes into consideration the special conditions of fractures in the growth period. There were 1.3 times more fractures in boys than in girls. Most fractures occurred at the age of thirteen to fourteen. Almost 90 % of the fractures were mono-injuries. Somatic pre-disposition factors (cerebral palsy or cystic bone tumours, e. g.) were found in 3.8 %. Most fractures were observed in the upper extremity (73.7 %) and in the metaphysis (65.1 %). The most injured regions were the distal forearm (41.6 %), the distal humerus (14.6 %) and the tibial shaft (10.8 %). Fractures of the shaft decreased after the age of ten, whereas articular fractures significantly increased at the end of adolescence. The most frequent cause was sports activity followed by accidents at home or on playgrounds. There was significant relation between distal humerus fractures in infants and playground accidents, distal forearm fractures and sports injuries, and tibia-fibula and ankle fractures after traffic accidents in teenagers.

Key words

fracture - adolescence - childhood - incidence - risk factors

References

  • 1 Benamghar L, Chau N, Saunier-Aptel E, Mergel B, Mur J M. Accidents among students in professional or technological schools in Lorraine.  Rev Epidemiol Sante Publique. 1998;  46 5-13
    PubMedGoogle Scholar
  • 2 Brudvik C, Hove L M. Childhood fractures in Bergen, Norway: Identifying high-risk groups and activities.  J Pediatr Orthop. 2003;  23 629-634
    PubMedGoogle Scholar
  • 3 Cheng J CY, Shen W Y. Limb fracture pattern in different pediatric age groups: a study of 3350 children.  J Orthop Trauma. 1993;  7 15-22
    CrossrefPubMedGoogle Scholar
  • 4 Chiolero A, Schmid H. Accidental morbidity in adolescence: a retrospective study in 12- to 15-year-old school children in Switzerland.  Schweiz Med Wochenschr. 2000;  130 1285-1290
    PubMedGoogle Scholar
  • 5 Hammarstrom A, Janlert U. Epidemiology of school injuries in the northern part of Sweden.  Scand J Soc Med. 1994;  22 120-126
    PubMedGoogle Scholar
  • 6 Jonasch E, Bertel E. Verletzungen bei Kindern bis zum 14. Lebensjahr.  Hefte Unfallheilkd. 1981;  150 1-146
    PubMedGoogle Scholar
  • 7 Jones I E, Williams S M, Dow N, Goulding A. How many children remain fracture-free during growth? A longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study.  Osteoporos Int. 2002;  13 990-995
    CrossrefPubMedGoogle Scholar
  • 8 Krabbe C A, Rutten J PB, Phiri Y, Heiji H A. Prevalence and outcome of paediatric and adolescent limb fractures in rural Zambia.  SAJS. 2003;  41 89-91
    PubMedGoogle Scholar
  • 9 Kramer C Y. Extension of multiple range tests to group means with unequal number of replications.  Biometrics. 1956;  12 307-310
    CrossrefPubMedGoogle Scholar
  • 10 Kraus R, Schneidmüller D, Röder C. Häufigkeit von Frakturen der langen Röhrenknochen im Wachstumsalter.  Dtsch Ärztebl. 2005;  102 838-842
    PubMedGoogle Scholar
  • 11 Landin L A. Fracture patterns in children. Analysis of 8682 fractures with special reference to incidence, etiology and secular changes in Swedish urban population 1950-1979.  Acta Orthop Scand. 1983;  202 (Suppl 1) 1-109
    PubMedGoogle Scholar
  • 12 Landin L A. Epidemiology of children's fractures.  J Pediatr Orthop. 1997;  6 79-83
    PubMedGoogle Scholar
  • 13 Mattila V, Parkkari J, Kannus P, Rimpela A. Occurrence and risk factors of unintentional injuries among 12- to 18-year-old Finns - a survey of 8 219 adolescents.  Eur J Epidemiol. 2004;  19 437-444
    PubMedGoogle Scholar
  • 14 Nordstrom D L, Zwerling C, Stromquist A M, Burmeister L F, Merchant J A. Identification of risk factors for non-fatal child injury in a rural area: Keokuk County Rural Health Study.  Inj Prev. 2003;  9 235-240
    CrossrefPubMedGoogle Scholar
  • 15 Radelet M A, Lephart S M, Rubinstein E N, Myers J B. Survey of the injury rate for children in community sports.  Pediatrics. 2002;  110 28-44
    CrossrefPubMedGoogle Scholar
  • 16 Scheidt P C, Harel Y, Trumble A C, Jones D H, Overpeck M D, Bijur P E. The epidemiology of nonfatal injuries among US children and youth.  Am J Public Health. 1995;  85 932-938
    CrossrefPubMedGoogle Scholar
  • 17 Sosnowska S, Kostka T. Epidemiology of school accidents during a six school-year period in one region in Poland.  Eur J Epidemiol. 2003;  18 977-982
    PubMedGoogle Scholar
  • 18 Tukey J W. Multiple comparisons.  J Amer Statist Assoc. 1953;  48 624-625
    PubMedGoogle Scholar
  • 19 Laer L, Gruber R, Dallek M, Dietz H G, Kurz W, Linhart W, Marzi I, Schmittenbecher P, Slongo T, Weinberg A, Wessel L. Classification and documentation of children's fractures.  Eur J Trauma. 2000;  26 2-14
    PubMedGoogle Scholar
  • 20 Laer L. Verletzungen im Bereich des Unterschenkelschaftes. In: von Laer L (Hrsg). Frakturen und Luxationen im Wachstumsalter. 4th Ed. Thieme, Stuttgart 2001; 364-375
    Google Scholar
  • 21 Worlock P, Stower M. Fracture patterns in Nottingham children.  J Pediatr Orthop. 1986;  6 656-660
    CrossrefPubMedGoogle Scholar

Dr. med. R. Kraus

Department of Trauma Surgery · Justus Liebig Universität · Gießen

Rudolf-Buchheim-Straße 7

35385 Gießen

Germany

Phone: +49/6 41/9 94 46 01

Fax: +49/6 41/9 94 46 09

Email: Ralf.Kraus@chiru.med.uni-giessen.de

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