Subscribe to RSS
DOI: 10.1055/s-2006-921365
© Georg Thieme Verlag Stuttgart · New York
Fractures of Long Bones in Children and Adolescents
Publication History
Publication Date:
02 March 2006 (online)
![](https://www.thieme-connect.de/media/osteotrauma/200601/lookinside/thumbnails/10.1055-s-2006-921365-1.jpg)
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
- 2 Brudvik C, Hove L M. Childhood fractures in Bergen, Norway: Identifying high-risk groups and activities. J Pediatr Orthop. 2003; 23 629-634
- 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
- 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
- 5 Hammarstrom A, Janlert U. Epidemiology of school injuries in the northern part of Sweden. Scand J Soc Med. 1994; 22 120-126
- 6 Jonasch E, Bertel E. Verletzungen bei Kindern bis zum 14. Lebensjahr. Hefte Unfallheilkd. 1981; 150 1-146
- 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
- 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
- 9 Kramer C Y. Extension of multiple range tests to group means with unequal number of replications. Biometrics. 1956; 12 307-310
- 10 Kraus R, Schneidmüller D, Röder C. Häufigkeit von Frakturen der langen Röhrenknochen im Wachstumsalter. Dtsch Ärztebl. 2005; 102 838-842
- 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
- 12 Landin L A. Epidemiology of children's fractures. J Pediatr Orthop. 1997; 6 79-83
- 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
- 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
- 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
- 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
- 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
- 18 Tukey J W. Multiple comparisons. J Amer Statist Assoc. 1953; 48 624-625
- 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
- 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
- 21 Worlock P, Stower M. Fracture patterns in Nottingham children. J Pediatr Orthop. 1986; 6 656-660
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