Epidemiology of fractures in children and adolescents

Hedström, Erik M; Svensson, Olle; Bergström, Ulrica; Michno, Piotr

doi:10.3109/17453671003628780

Cited by 423 publications

(422 citation statements)

References 20 publications

Supporting

Mentioning

333

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, the lower BMD observed in teenagers with late puberty has clinical relevance, because this is a period of high fracture incidence. (20,(31)(32)(33) In our cohort, a 28% increased risk of having had a previous fracture during childhood, adolescence, and young adulthood (up until the age of 24 years) for each year age at PHV increased, was observed.…”

Section: Pubertal Timing and Bmd In Adolescentsmentioning

confidence: 76%

Catch up in bone acquisition in young adult men with late normal puberty

Darelid

Ohlsson

Nilsson

et al. 2012

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

The aim of this study was to investigate the development of bone mineral density (BMD) and bone mineral content (BMC) in relation to peak height velocity (PHV), and to investigate whether late normal puberty was associated with remaining low BMD and BMC in early adulthood in men. In total, 501 men (mean AE SD, 18.9 AE 0.5 years of age at baseline) were included in this 5-year longitudinal study. Areal BMD (aBMD) and BMC, volumetric BMD (vBMD) and cortical bone size were measured using dual-energy X-ray absorptiometry (DXA) and pQCT. Detailed growth and weight charts were used to calculate age at PHV, an objective assessment of pubertal timing. Age at PHV was a strong positive predictor of the increase in aBMD and BMC of the total body (R 2 aBMD 11.7%; BMC 4.3%), radius (R 2 aBMD 23.5%; BMC 22.3%), and lumbar spine (R 2 aBMD 11.9%; BMC 10.5%) between 19 and 24 years (p < 0.001). Subjects were divided into three groups according to age at PHV (early, middle, and late). Men with late puberty gained markedly more in aBMD and BMC at the total body, radius, and lumbar spine, and lost less at the femoral neck (p < 0.001) than men with early puberty. At age 24 years, no significant differences in aBMD or BMC of the lumbar spine, femoral neck, or total body were observed, whereas a deficit of 4.2% in radius aBMD, but not in BMC, was seen for men with late versus early puberty (p < 0.001). pQCT measurements of the radius at follow-up demonstrated no significant differences in bone size, whereas cortical and trabecular vBMD were 0.7% (p < 0.001) and 4.8% (p < 0.05) lower in men with late versus early puberty. In conclusion, our results demonstrate that late puberty in males was associated with a substantial catch up in aBMD and BMC in young adulthood, leaving no deficits of the lumbar spine, femoral neck, or total body at age 24 years. ß

show abstract

Section: Pubertal Timing and Bmd In Adolescentsmentioning

confidence: 76%

Catch up in bone acquisition in young adult men with late normal puberty

Darelid

Ohlsson

Nilsson

et al. 2012

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…The main findings were that the incidence of fractures and surgical treatment increased markedly in preteen children beginning towards the end of the 1990s. The overall incidence of pediatric fractures has increased since the 1950s, but according to Mäyränpää et al's population-based study the trend changed has during the last two decades [4,22], with the incidence of all but upper-extremity fractures significantly decreasing [22]. In their Finnish population-based study on the incidence of hospital-treated upper-extremity fractures, Helenius and co-workers [5] reported a 23 % increase in fractures and 28 % increase in operative management during the past 10 years.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010

Salonen

Pajulo

Lahdes-Vasama

et al. 2013

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Background Studies of pediatric and adolescent fractures in general report a significant increase in the incidence of upper-extremity fractures as well as in their surgical treatment. The aim of this study was to determine the trends of the incidence and treatment of distal humeral fractures in hospitalized 0-to 18-year-old patients in Finland. Method The study included the entire pediatric and adolescent (\19 years) population in Finland during the 24-year period from 1 January 1987 to 31 December 2010. Data on hospitalized patients were obtained from the nationwide National Hospital Discharge Registry where information is collected from all hospital categories (private, public, and other). Surgical treatment was categorized into three groups; (1) reposition with casting; (2) reposition or reduction and osteosynthesis; (3) reposition or reduction and external-fixation and other fixation methods. Patients were classified into three groups according to age: 0-6 years, 7-13 years, and 14-18 years. Annual incidences were calculated using the annual mid-year population census obtained from the Official Statistics of Finland. Results During the 24-year study period, there were a total of 12,590 hospitalizations with a main or secondary diagnosis of distal humeral fracture. In children aged 0-12 years the overall incidence of hospitalization increased 30 % during the 24-year study period, from 4.5 per 10,000 person-years in 1987 to 5.8 per 10,000 person-years in 2010. There were a total of 5,548 operations. During the study period, surgical treatment by repositioning or reduction with osteosynthesis due to a distal humeral fracture increased by fivefold in patients aged\6 years and by twofold in patients aged 7-12 years of age. The incidences of fracture and treatment in children older than 13 years did not change. Conclusion The incidence of distal humeral fractures and the incidence of repositioning with osteosynthesis increased remarkably in prepubertal children during the 24-year study period in Finland.

show abstract

“…The occurrence of fracture in the forearms, hands, and feet of children is high, particularly in the ankles, with a global incident rate of 187 per 100,000 people. However, incidence rates vary among countries, ages, sexes and sites of injury (1)(2)(3). Due to the specific characteristics of children's bones, delayed and/or improper treatment of ankle fracture in children may cause bone deformity and disability (4,5).…”

Section: Introductionmentioning

confidence: 99%

N‑methyl pyrrolidone promotes ankle fracture healing by inhibiting inflammation via suppression of the mitogen‑activated protein kinase signaling pathway

et al. 2018

View full text Add to dashboard Cite

Abstract. N-methyl pyrrolidone (NMP), a small bioactive molecule, has the potential to stimulate bone formation and inhibit osteoclast differentiation. The aim of the present study was to investigate the effect of NMP on the inflammatory response and underlying molecular mechanisms in MG-63 cells. The mRNA and protein expression of cytokines from peripheral blood in children with or without ankle fracture were determined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and ELISA, respectively. MG-63 cells were pre-treated with/without NMP and stimulated with 1 µM bradykinin (BK). The production of cytokines from MG-63 cells was assessed by western blotting and RT-qPCR. The expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) mRNA and protein were measured using western blotting and/or RT-qPCR. Western blotting was used to examine the activation level of mitogen activated protein kinase. Compared with healthy children, levels of tumor necrosis factor (TNF-α), interleukin (IL)-1β and IL-6 mRNA and protein were upregulated in children with ankle fracture. NMP treatment did not induce cytotoxicity in MG-63 cells. The BK-induced upregulation of TNF-α, IL-1β, IL-6, iNOS and COX-2 mRNA and protein was reversed in a dose-dependent manner by NMP. Furthermore, NMP downregulated the activation of c-Jun NH2-terminal kinase and p38 pathways, but not the extracellular signal-related kinase pathway. Therefore, the results of the current study demonstrate that NMP inhibits inflammation dependent on the mitogen-activated protein kinase pathway in MG-63 cells, indicating that it may be beneficial in the healing of fractures.

show abstract

Epidemiology of fractures in children and adolescents

Cited by 423 publications

References 20 publications

Catch up in bone acquisition in young adult men with late normal puberty

Catch up in bone acquisition in young adult men with late normal puberty

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010

N‑methyl pyrrolidone promotes ankle fracture healing by inhibiting inflammation via suppression of the mitogen‑activated protein kinase signaling pathway

Contact Info

Product

Resources

About