Epidemiology of Fractures in Children Younger Than 12 Months

Rodà, Diana; Trenchs, Victoria; Curcoy, Ana Isabel; Martínez, Anibal Dolores; Pou, Jordi; Luaces, Carles

doi:10.1097/pec.0000000000001157

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…Again, fractures to the clavicle predominated [ 15 ]. Similar findings have been reported by others, however, with no incidences given [ 18 , 19 ].…”

Section: Discussionsupporting

confidence: 92%

Incidence, pattern and mechanisms of injuries and fractures in children under two years of age

Rosendahl

Myklebust²,

Ulriksen³

et al. 2021

BMC Musculoskelet Disord

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Background Fractures in children under 2 years of age are rare, and little has been published on their mechanisms. We aimed at examining the incidence, mechanisms, pattern and fracture characteristics in a large, population-based cohort of otherwise healthy children. Methods This retrospective, cross-sectional study includes all children aged 0–2 years, attending the Accident and Emergency department in Bergen between 2010 and 2015, due to an injury warranting radiography. Clinical data was categorized from the medical notes, and all radiographs were reviewed by an experienced paediatric radiologist. Results In total 408 children (212 male), 3–23 months of age (mean 17.7 months), were included. 149 (77 male) children had a total of 162 fractures, yielding an annual incidence of 5.4 per 1000, varying from 0.7 per 1000 for those under 12 months of age, increasing tenfold to 7.3 per 1000 for children aged 12–24 months of age. More than half of the fractures (53.1%) were seen in children aged 18–23 months, while none was found in those under 7 months of age. The youngest age group had mostly femur and tibia fractures, the oldest mostly forearm fractures (n = 55, 33.9%), followed by tibia fractures (21.6%) and fractures to the clavicle (14.8%). The reported mechanisms for the 162 fractures were fall from a chair/bed/table (41.4%), fall from own height (18.5%) or crush injury (15.4%). In 8 of 162 (4.9%) fractures, the history was clearly inconsistent and suspicious of non-accidental injury (NAI). Conclusion Injuries and fractures in young children in general, and non-ambulant children in particular, are rare and should be thoroughly assessed for NAI. Level of evidence: Retrospective, population based cross-sectional study. Level 3.

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“…Again, fractures to the clavicle predominated [ 15 ]. Similar findings have been reported by others, however, with no incidences given [ 18 , 19 ].…”

Section: Discussionsupporting

confidence: 92%

Incidence, pattern and mechanisms of injuries and fractures in children under two years of age

Rosendahl

Myklebust²,

Ulriksen³

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The current study found an incidence of humerus shaft fracture later during infancy of 0.073‰. A previous hospital study reported that among 101 children younger than 12 months treated at an emergency clinic, 2 patients were diagnosed with a humerus shaft fracture [17].…”

Section: Discussionsupporting

confidence: 52%

“…Ethics approval and consent to participate The study was approved by the Regional Ethical Committee in Uppsala, Sweden (2014- [11][12][13][14][15][16][17][18][19]No. 383).…”

Section: Declarationsmentioning

confidence: 99%

The Epidemiology of Infant Shaft Fractures of Femur or Humerus by Incidence, Birth, Accidents, and Other Causes

Iversen

Thiblin

Högberg

2020

Preprint

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Background: Knowledge of femur and humerus shaft fractures during infancy is scarce. The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and those diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents.Methods: Children born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1-7 without registered trauma, abuse, or bone fragility disorders. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population. Results: The incidence for birth-related femur shaft fractures was 0.024‰ (n=45) and that for birth-related humerus shaft fractures was 0.101‰ (n=188). The incidence was 0.154‰ for later femur shaft fractures (n=287) and 0.073‰ for later humerus shaft fractures (n=142). Birth-related femur shaft fracture was associated with preterm, multiple birth, breech, cesarean, and small-for-gestational age, while humerus shaft fracture was associated with preterm, multiple birth, birth weight > 4,000 g, and shoulder dystocia. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with both fracture types, especially among those aged < 6 months, where approximately 20% and 14% of cases, respectively, were associated with abuse. Fall accidents were reported in 73% and 56% among those with later femur and humerus shaft fractures, respectively. Conclusion: This study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.

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“…The current study found an incidence of later diagnosed humerus shaft fractures of 0.073 per 1000 children, being more prevalent during first 6 months of first year. A previous hospital study reported that among 101 children younger than 12 months treated at an emergency clinic, 2 patients were diagnosed with a humerus shaft fracture [ 20 ]. Another study reported an incidence of 0.17 per 1000 children ( n = 3) in children aged < 24 months [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes

Heideken

Thiblin

Högberg

2020

BMC Musculoskelet Disord

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Background The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents. Methods Children born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1–7 without registered trauma or abuse. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population. Results The incidence for birth-related femur shaft fractures was 0.024 per 1000 children (n = 45) and that for birth-related humerus shaft fractures was 0.101 per 1000 children (n = 188). The incidence was 0.154 per 1000 children for later femur shaft fractures (n = 287) and 0.073 per 1000 children for later humerus shaft fractures (n = 142). Birth-related femur shaft fracture was associated with shoulder dystocia, cesarean, multiple birth, breech, preterm, and small-for-gestational age, while humerus shaft fracture was associated with maternal obesity, dystocic labor, shoulder dystocia, vacuum-assisted delivery, male sex, multiple birth, breech, preterm, large-for-gestational age, birth weight > 4000 g, and injury of brachial plexus. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with later fractures of both types, especially among those aged < 6 months, where approximately 20% (femur) and 14% (humerus) of cases, respectively, were associated with abuse. Fall accidents were reported in 73 and 56% among those with later femur and humerus shaft fractures, respectively. Conclusion This study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.

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Epidemiology of Fractures in Children Younger Than 12 Months

Cited by 10 publications

References 23 publications

Incidence, pattern and mechanisms of injuries and fractures in children under two years of age

Incidence, pattern and mechanisms of injuries and fractures in children under two years of age

The Epidemiology of Infant Shaft Fractures of Femur or Humerus by Incidence, Birth, Accidents, and Other Causes

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes

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