Epidemiology of paediatric elbow fractures: A retrospective multi-centre study of 488 fractures

Abstract

PurposeElbow fractures are common in children and occur during daily activities. The aim of this study is to evaluate the epidemiology of paediatric elbow fractures over a two-year period in Okinawa, a southern subtropical island in Japan.MethodsThis was a retrospective study of 488 elbow fractures in children younger than 15 years old treated at 11 hospitals in Okinawa. Data included age, gender, calendar month, type of fracture, operation rate, mechanism of injury, and aetiology.ResultsThe most frequent age was 6 years old, with 47.5% of all elbow fractures occurring in an age range from 6 to 10 years old. The fracture rate for boys was 1.6 times higher than that for girls. The incidence was the highest in May (56 fractures) and the lowest in August (25 fractures). Supracondylar fractures were the most common type (44%), followed by lateral condyle fractures (22%); 45% of all fractures were treated operatively. Medial epicondyle fractures had the highest rate of operative treatment (91%). In the 6 to 10-year-old group, 19% of all fractures occurred while skateboarding or caster-boarding, the most frequent aetiology.ConclusionsSupracondylar fractures are the most common fracture type in 4 to 7-year-old boys. In the 6 to 10-year-old group, skateboarding and caster-boarding are the most frequent and increasing cause of elbow fractures. Therefore, some preventive measures are needed.Level of evidenceLevel IV, case series

Elbow Fracture in Children at Saiful Anwar General Hospital, Nine Years Experiences

“…Conservative treatments were chosen primarily in nondisplaced and isolated elbow fracture which stabilized by immobilization. This is in contrast with the previous epidemiology study from Houshian et al which applied a much more conservative method for the treatment of the elbow fracture in children [14], but in line with the study investigated by Okubo et al [2] in the term of higher operative rate for Gartland type II and type III supracondylar fractures (50% and 100% operative rate). In this study, the most common injury is Gartland type III, thus the operative method rate is higher.…”

“…Similar result about the occurrence of supracondylar fractures is reported by Okubo et al in the study about pediatric elbow fractures. It is reported that the number of supracondylar fractures is the most compared to other elbow fracture in pediatric population with 214 cases from the total of 488 patient populations [2].…”

“…Elbow fracture in pediatric patients is a great encumbrance treated in a trauma hospital [1]. The total incidence of elbow fractures was 30.8/10000 each year [2]. The majority of injury mechanism comes from fall in an outstretched hand [3].…”

“…The complications of elbow fractures include malunion or nonunion of the fracture fragments, stiffness, and neurovascular injury especially the ulnar nerve [4]. Determination of the etiology is important because children's activities are different in each country [2].…”

One additional shot of brachial plexus block equates to less postoperative pain for younger children with elbow surgeries

“…In displaced LCFH and MCFH, open reduction and internal fixation (ORIF) is our preferred choice and usually yields satisfactory outcomes [27,28]. Whereas, closed reduction and percutaneous pinning (CRPP) remains the primary choice for displaced SCFH [29]. Regardless of the fracture type and operative choice, the pain response was significantly lower in the GA + BPB group in our study.…”