Patterns of Accidental Fractures and Dislocations in Children in Riyadh, Saudi Arabia

Abstract

A study of 1456 confirmed cases of accidental fractures and dislocations in children was conducted to examine the patterns of fractures and dislocations, age and sex distribution, and the causes and possible prevention of such mishaps. Dislocations were uncommon and accounted for less than 1% of the total. There were more fractures of the upper than lower limbs, and the most commonly encountered fractures were: forearm (39.6%), humerus (12%), clavicle (11%), tibia and fibula (10.6%), and femur (5.6%). The male to female ratio was 2.3 to 1, and the risk of injury appeared to be higher in preschool children (2-6 years) and in adolescents (12-14 years). Non-road traffic accidents were the cause of 93% of the cases. It was concluded that supervision of the younger age groups and health education of the older age groups may decrease the incidence of injury in children.

A Rare Case of Femoral Neck Fracture in a Six-Year-Old Girl

“…Type I fractures are transphyseal, while types II, III, and IV are transcervical, cervicotrochanteric, and intertrochanteric fractures, respectively. This anatomic fracture classification is prognostic of long-term outcomes as well as the main complication of pediatric femoral neck fractures, osteonecrosis [ 1 , 2 , 8 , 16 ]. Osteonecrosis occurs in 16-47% of pediatric proximal femoral fractures [ 1 , 2 ].…”

“…Ratliff classified acute osteonecrosis of the femoral head and neck as radiographic sclerosis and collapse of the head (type I), focal sclerosis superior lateral head (type II), or sub-capital neck (type III) with preservation of the epiphyseal supply [ 5 , 17 , 18 ]. Many authors report that the long-term outcomes of management of Delbet type I fractures are worse when compared to other Delbet type fractures [ 1 , 2 , 6 , 8 , 15 ]. Sub-capital or Salter-Harris type I fractures with complete dislocation of the epiphysis (i.e., Delbet type IB) are universally thought to progress to osteonecrosis regardless of treatment.…”

“…It is also associated with a risk of possible long-term dysfunction and adverse complications [5][6][7]. In Saudi Arabia, a study of 1456 diagnosed cases of accidental fractures and dislocations in children was carried out to assess the patterns of fractures and dislocations [8]. The result showed that the most commonly stumble-on fractures were the forearm (39.6%), humerus (12%), clavicle (11%), tibia and fibula (10.6%), and femur (5.6%).…”

“…Dysfunction and pain are the most frequently reported complications in 20-50% of all patients. These complications are due to osteonecrosis, coxa valga, proximal femoral physeal growth arrest, and non-union [1][2][3][7][8][9][10].…”