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Abstract
Materials and Methods
The records of the 589 in-patient children treated for upper extremity fractures over a 1-year period at 7 different hospitals were collected prospectively and analyzed. The severity of trauma was classified as slight, moderate or severe. This study examined the incidence of various upper extremity fractures and performed statistical analysis according to the epidemiologic parameters including age, gender and season.
Results
The average age of the children was 7.8 years. The average age of boys (8.5 years) was older than girls (6.4 years). The majority of fractures occurred at between 4 and 7 years of age (36%). The male to female ratio was approximately 2:1. The male predominance increased with age and increased dramatically in the age group, 12-16 years (5.8:1). The left side was injured more frequently (56%), and there was no difference between genders. The occurrence of fractures varied with the seasons with peaks in May (14.1%) and August (12.2%), and it was closely related to the temperature (r=0.778). The most common fractures were the supracondylar fractures of the humerus (32.6%), followed by distal radius fractures (18.2%), lateral condylar fractures (15.8%), radio-ulna shaft fractures (8%), clavicle fractures (4.2%), proximal humerus fractures (2.6%) and humerus shaft fractures (2.4%). Ninety seven percent of fractures were caused by a slight and moderate trauma. Fifty four percent of injured children underwent surgery, and 84% of operations were performed on the fractures around the elbow.
Figures and Tables
Fig. 1
The incidence of upper extremity fractures according to age. The age for the peak incidence of upper extremity fractures was 8 years. In boys the age for the peak incidence was 8 years, but in girls the peak incidence occurred at 5 years.
Fig. 2
The distribution of upper extremity fractures according to age groups. The incidence of upper extremity fractures of boys was almost same in the group older than 4 years of age, but the incidence was decreased among girls aged between 12 and 16 years.
Fig. 3
The side of involvement. The fractures were more common on the left side than on the right side in all age groups.
Fig. 4
The seasonal variations. The occurrence of fractures varied with seasons with peak value occurring in May and August and low values in January.
Fig. 5
The weekly variations. The occurrence of fractures increased on the weekend, but interestingly, the children at the age between 12 and 16 years did not show this trend.
Fig. 6
The distribution of various fractures within the age groups. The peak incidence of clavicle fractures was less than 3 years of age, supracondylar. The peak incidence of lateral condylar fractures occurred between 4 and 7 years. The peak incidence of forearm and humerus fractures occurred between 12 and 16 years.
Fig. 7
The regional distribution of fractures within the age groups. Fractures around the elbow were more common in those aged between 4 and 7 years. Fractures around the shaft and the distal part of forearm were more common between 12 and 16 years. Fractures around the shoulder were more common in those less than 3 years.
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