Research Article
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Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department

Year 2018, Volume: 8 Issue: 3, 211 - 217, 30.09.2018
https://doi.org/10.16899/gopctd.454562

Abstract

A
B S T R A C T



Introduction:
Serious and potentially fatal multi-trauma in childhood can rarely
be seen.
However,
each one of 5 children is exposed to
minor trauma. Our aim is to reveal upper extremity
traumas, trauma mechanisms and seasonal relationship in children under 18 years
of age.



Patients
and methods:
In this retrospective
study, the files and graphs of 500 patients under 18 years old who applied to
Tokat Gaziosmanpaşa University Medical Faculty Emergency Service after trauma
were examined through Enlil and PACS system. 328 patients with upper extremity
pathology were included in the study. These patients were analyzed according to
different age groups (0-4,5-8,9-12,13-17).



Results:
500 patients were screened and 328 patients (65.6%) with upper
extremity trauma were included. 109 (33.23%) patients were female and 209
(66.77%) patients were male. The most frequent 0-4 year upper extremity traumas
(n = 39) in girls were found to decrease with age. In boys, it was found that
the upper extremity traumas increased with age, the most common age was 13-17
(n = 79). The distal radius fracture (n = 64) and distal humerus fracture (n =
61) were the most common in upper extremity traumas. The highest falling down
in the etiology of 328 patients with upper extremity pathology
(n = 149, 45.43%) was detected. It was determined
that traumatic upper extremity pathologies were followed most in summer
(36.58%) followed by autumn, spring and winter respectively.



Conclusion:
Two
- thirds of children under 18 years old who applied for trauma were admitted
due to upper extremity trauma. It was found that fracture of the distal radius
(n = 87) was the most (33.85%) when the isolated radius fractures, bilateral
forearm fractures, and upper extremity multiple fractures were evaluated
together in children.

References

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  • 2. Spady DW, Saunders DL, Schopflocher DP, Svenson LW. Patterns of injury in children: a population-based approach. Pediatrics 2004;113(3 Pt 1):522-9.
  • 3. Currey JD, Butler G. The mechanical properties of bone tissue in children. J Bone Joint Surg Am 1975;57(6):810-4.
  • 4. Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop Relat Res 1998; (355 Suppl):S7-21.
  • 5. Jacobsen FS. Periosteum: its relation to pediatric fractures. J Pediatr Orthop B 1997;6(2):84-90.
  • 6. Wallace ME, Hoffman EB. Remodelling of angular deformity after femoral shaft fractures inchildren. J Bone Joint Surg Br 1992;74(5):765-9.
  • 7. Kalender Ö, Gürcü T, Reisoğlu A, Ağuş H. Acil servise kırık nedeniyle başvuran çocuk hastalarda kırıkların sıklık ve dağılımı. Acta Orthop Traumatol Turc 2006; 40: 384-387.
  • 8. Taviloğlu K, Aydın A, Çuhalı BD, ve ark. Olgularımızın birinci derece travma merkezine sevk edilme kriterlerine uygunluğunun değerlendirilmesi. Ulusal Travma Dergisi 2001; 7: 146-150.
  • 9. Ritsema TS, Kelen GD, Pronovost PJ, Pham JC. The national trend in quality of emergency department pain management for long bone fractures. Acad Emerg Med 2007; 14: 163-169.
  • 10. Hadjidakis DJ, Kokkinakis EP, Sfakianakis ME, Raptis SA. Bone density patterns after normal and premature menopause. Maturitas 2003; 44: 279-286.
  • 11. Injuries in the European Union, summary on injury statistics 2012–14. www. eurosafe.eu.com, 2016.
  • 12. Auner B, Marzi I. Pediatric multiple trauma. Chirurg 2014;85:451.
  • 13. Meier R, Krettek C, Grimme K, Regel G, Remmers D, Harwood P, et al. The multiply injured child. Clin Orthop Relat Res 2005;12:7–13 1.
  • 14. Albert M, McCaig LF. Injury-related emergency department visits by children and adolescents: United States, 2009–2010. Acad Emerg Med 2014;11:1–8.
  • 15. Ruffing T, Danko S, Danko T, Henzler T, Winkler H. Verletzungen bei Kindern und Jugendlichen im Bereitschaftsdienst. Dtsch Arztebl 2015;119:654.
  • 16. Snyder CW, Muensterer OJ, Sacco F, Safford SD. Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children. Int J Circumpolar Health 2014;73.
  • 17. Wilkins KE. The incidence of fractures in children. In: Rockwood CA, Wilkins KE, Beaty JH. Fractures in children. Vol.3, 4th ed. Philadelphia: Lippincott-Raven, 1996: 3-17.
  • 18. Kalender Ö, Gürcü T, Reisoğlu A, Ağuş H. Acil servise kırık nedeniyle başvuran çocuk hastalarda kırıkların sıklık ve dağılımı. Acta Orthop Traumatol Turc 2006; 40: 384-387.
  • 19. McKenzie LB, Fletcher E, Nelson NG, Roberts KJ, Klein EG. Epidemiology of skateboarding-releated injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008. Inl Epidemiol. 2016 Dec;3(1):10.Epub 2016 Apr 8.
  • 20. Benoit R,Watts DD, Dwyer K, et al. Windows 99: a source of suburban pediatric trauma. J Trauma 2000;49:477–81. discussion 481-482.
  • 21. Keogh S, Gray JS, Kirk CJ, et al. Children falling from a height in London. Inj Prev 1996;2:188–91.
  • 22. Ong ME, Ooi SB, Manning PG. A review of 2,517 childhood injuries seen in a Singapore emergency department in 1999—mechanisms and injury prevention suggestions. Singapore Med J 2003;44:12–9.
  • 23. Lallier M, Bouchard S, St-Vil D, et al. Falls from heights among children: a retrospective review. J Pediatr Surg 1999;34:1060–3.
  • 24. Joeris A, Lutz N, Wicki B, Slongo T, Audigé L. An epidemiological evalua¬tion of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals. BMC Pediatr 2014; 14: 314.
  • 25. Mathison DJ, Agrawal D. An update on the epidemiology of pediatric frac¬tures. Pediatr Emerg Care 2010; 26: 594-603.
  • 26. Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007 Aug;38(8):913-22. Epub 2007 Jul 12.
  • 27. Karl JW, Olson PR, Rosenwasser MP. The Epidemiology of Upper Extremity Fractures in the United States, 2009. J Orthop Trauma. 2015 Aug;29(8):e242-4.
  • 28. England SP, Sundberg S. Management of common pediatric fractures. Pediatr Clin North Am. 1996;43(5):991-1012.
  • 29. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res 1994(300):127-32.
  • 30. Rubin G, Peleg K, Givon A, Rozen N. Upper extremity open fractures in hospitalized road traffic accident patients: adult versuspediatric cases. J Orthop Surg Res. 2017 Oct 24;12(1):157.
  • 31. Zararsız İ, Kaya E, Savaş N, Meydan S, Davran S, Tutanç M, Duru M. Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Acil Servise Kırık Nedeniyle Başvuran Hastalarda Kırık Dağılımı ve Sıklığı. 2009, Cilt 23, Sayı 3, Sayfa(lar) 155-158. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
  • 32. Pahlavan S, Baldwin KD, Pandya NK, Namdari S, Hosalkar H. Proximal humerus fractures in the pediatric population: a systematic review. J Child Orthop 2011;5(3):187-94.
  • 33. Garg S, Dobbs MB, Schoenecker PL, Luhmann SJ, Gordon JE. Surgical treatment of traumatic pediatric humeral diaphyseal fractures with titanium elastic nails. J Child Orthop 2009;3(2):121-7.
  • 34. Shaw BA, Murphy KM, Shaw A, Oppenheim WL, Myracle MR. Humerus shaft fractures in young children: accident or abuse? J Pediatr Orthop 1997;17(3):293-7.
  • 35. Kumar V, Singh A. Fracture supracondylar humerus: A Review. J Clin Diagn Res 2016; 10(12):RE01-RE6.
  • 36. Skaggs D, Pershad J. Pediatric elbow trauma. Pediatr Emerg Care 1997;13(6):425-34.
  • 37. Rodriguez-Merchan EC. Pediatric fractures of the forearm. Clin Orthop Relat Res 2005;(432):65-72.
  • 38. Randsborg PH, Gulbrandsen P, Saltyte Benth J, et al. Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am 2013;95(7):e42.
  • 39. Huntley SR, Summers SH, Stricker SJ. Salter-Harris type-IV displaced distal radius fracture in a 5-year-old. J Pediatr Orthop B 2016;25(2):170-3.
  • 40. Herring JA. Upper extremity injuries. In: Tachdjian MO (ed). Pediatric Orthopedics, 3rd edition, Vol: 3. WB Saunders Comp, Philadelphia, 2002: 2191-4.
  • 41. Wilkins KE. Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, Richard EK (eds). Fractures in children, 1st edition, Vol: 3. Lippincott Comp, Philadelphia, 1984: 530-53.
  • 42. Papandrea R, Waters PM. Posttraumatic reconstruction of the elbow in the pediatric patient. Clin Orthop 2000; 370: 115-26.
Year 2018, Volume: 8 Issue: 3, 211 - 217, 30.09.2018
https://doi.org/10.16899/gopctd.454562

Abstract

References

  • 1.Cooper C, Dennison EM, Leufkens HG, Bishop N, van Staa TP. Epidemiology of childhood fractures in britain: a study using the general practice research database. J Bone Miner Res 2004;19(12):1976-81.
  • 2. Spady DW, Saunders DL, Schopflocher DP, Svenson LW. Patterns of injury in children: a population-based approach. Pediatrics 2004;113(3 Pt 1):522-9.
  • 3. Currey JD, Butler G. The mechanical properties of bone tissue in children. J Bone Joint Surg Am 1975;57(6):810-4.
  • 4. Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop Relat Res 1998; (355 Suppl):S7-21.
  • 5. Jacobsen FS. Periosteum: its relation to pediatric fractures. J Pediatr Orthop B 1997;6(2):84-90.
  • 6. Wallace ME, Hoffman EB. Remodelling of angular deformity after femoral shaft fractures inchildren. J Bone Joint Surg Br 1992;74(5):765-9.
  • 7. Kalender Ö, Gürcü T, Reisoğlu A, Ağuş H. Acil servise kırık nedeniyle başvuran çocuk hastalarda kırıkların sıklık ve dağılımı. Acta Orthop Traumatol Turc 2006; 40: 384-387.
  • 8. Taviloğlu K, Aydın A, Çuhalı BD, ve ark. Olgularımızın birinci derece travma merkezine sevk edilme kriterlerine uygunluğunun değerlendirilmesi. Ulusal Travma Dergisi 2001; 7: 146-150.
  • 9. Ritsema TS, Kelen GD, Pronovost PJ, Pham JC. The national trend in quality of emergency department pain management for long bone fractures. Acad Emerg Med 2007; 14: 163-169.
  • 10. Hadjidakis DJ, Kokkinakis EP, Sfakianakis ME, Raptis SA. Bone density patterns after normal and premature menopause. Maturitas 2003; 44: 279-286.
  • 11. Injuries in the European Union, summary on injury statistics 2012–14. www. eurosafe.eu.com, 2016.
  • 12. Auner B, Marzi I. Pediatric multiple trauma. Chirurg 2014;85:451.
  • 13. Meier R, Krettek C, Grimme K, Regel G, Remmers D, Harwood P, et al. The multiply injured child. Clin Orthop Relat Res 2005;12:7–13 1.
  • 14. Albert M, McCaig LF. Injury-related emergency department visits by children and adolescents: United States, 2009–2010. Acad Emerg Med 2014;11:1–8.
  • 15. Ruffing T, Danko S, Danko T, Henzler T, Winkler H. Verletzungen bei Kindern und Jugendlichen im Bereitschaftsdienst. Dtsch Arztebl 2015;119:654.
  • 16. Snyder CW, Muensterer OJ, Sacco F, Safford SD. Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children. Int J Circumpolar Health 2014;73.
  • 17. Wilkins KE. The incidence of fractures in children. In: Rockwood CA, Wilkins KE, Beaty JH. Fractures in children. Vol.3, 4th ed. Philadelphia: Lippincott-Raven, 1996: 3-17.
  • 18. Kalender Ö, Gürcü T, Reisoğlu A, Ağuş H. Acil servise kırık nedeniyle başvuran çocuk hastalarda kırıkların sıklık ve dağılımı. Acta Orthop Traumatol Turc 2006; 40: 384-387.
  • 19. McKenzie LB, Fletcher E, Nelson NG, Roberts KJ, Klein EG. Epidemiology of skateboarding-releated injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008. Inl Epidemiol. 2016 Dec;3(1):10.Epub 2016 Apr 8.
  • 20. Benoit R,Watts DD, Dwyer K, et al. Windows 99: a source of suburban pediatric trauma. J Trauma 2000;49:477–81. discussion 481-482.
  • 21. Keogh S, Gray JS, Kirk CJ, et al. Children falling from a height in London. Inj Prev 1996;2:188–91.
  • 22. Ong ME, Ooi SB, Manning PG. A review of 2,517 childhood injuries seen in a Singapore emergency department in 1999—mechanisms and injury prevention suggestions. Singapore Med J 2003;44:12–9.
  • 23. Lallier M, Bouchard S, St-Vil D, et al. Falls from heights among children: a retrospective review. J Pediatr Surg 1999;34:1060–3.
  • 24. Joeris A, Lutz N, Wicki B, Slongo T, Audigé L. An epidemiological evalua¬tion of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals. BMC Pediatr 2014; 14: 314.
  • 25. Mathison DJ, Agrawal D. An update on the epidemiology of pediatric frac¬tures. Pediatr Emerg Care 2010; 26: 594-603.
  • 26. Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007 Aug;38(8):913-22. Epub 2007 Jul 12.
  • 27. Karl JW, Olson PR, Rosenwasser MP. The Epidemiology of Upper Extremity Fractures in the United States, 2009. J Orthop Trauma. 2015 Aug;29(8):e242-4.
  • 28. England SP, Sundberg S. Management of common pediatric fractures. Pediatr Clin North Am. 1996;43(5):991-1012.
  • 29. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res 1994(300):127-32.
  • 30. Rubin G, Peleg K, Givon A, Rozen N. Upper extremity open fractures in hospitalized road traffic accident patients: adult versuspediatric cases. J Orthop Surg Res. 2017 Oct 24;12(1):157.
  • 31. Zararsız İ, Kaya E, Savaş N, Meydan S, Davran S, Tutanç M, Duru M. Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Acil Servise Kırık Nedeniyle Başvuran Hastalarda Kırık Dağılımı ve Sıklığı. 2009, Cilt 23, Sayı 3, Sayfa(lar) 155-158. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
  • 32. Pahlavan S, Baldwin KD, Pandya NK, Namdari S, Hosalkar H. Proximal humerus fractures in the pediatric population: a systematic review. J Child Orthop 2011;5(3):187-94.
  • 33. Garg S, Dobbs MB, Schoenecker PL, Luhmann SJ, Gordon JE. Surgical treatment of traumatic pediatric humeral diaphyseal fractures with titanium elastic nails. J Child Orthop 2009;3(2):121-7.
  • 34. Shaw BA, Murphy KM, Shaw A, Oppenheim WL, Myracle MR. Humerus shaft fractures in young children: accident or abuse? J Pediatr Orthop 1997;17(3):293-7.
  • 35. Kumar V, Singh A. Fracture supracondylar humerus: A Review. J Clin Diagn Res 2016; 10(12):RE01-RE6.
  • 36. Skaggs D, Pershad J. Pediatric elbow trauma. Pediatr Emerg Care 1997;13(6):425-34.
  • 37. Rodriguez-Merchan EC. Pediatric fractures of the forearm. Clin Orthop Relat Res 2005;(432):65-72.
  • 38. Randsborg PH, Gulbrandsen P, Saltyte Benth J, et al. Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am 2013;95(7):e42.
  • 39. Huntley SR, Summers SH, Stricker SJ. Salter-Harris type-IV displaced distal radius fracture in a 5-year-old. J Pediatr Orthop B 2016;25(2):170-3.
  • 40. Herring JA. Upper extremity injuries. In: Tachdjian MO (ed). Pediatric Orthopedics, 3rd edition, Vol: 3. WB Saunders Comp, Philadelphia, 2002: 2191-4.
  • 41. Wilkins KE. Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, Richard EK (eds). Fractures in children, 1st edition, Vol: 3. Lippincott Comp, Philadelphia, 1984: 530-53.
  • 42. Papandrea R, Waters PM. Posttraumatic reconstruction of the elbow in the pediatric patient. Clin Orthop 2000; 370: 115-26.
There are 42 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Mehmet Esen 0000-0003-2180-6946

Hilal Irmak Sapmaz 0000-0002-9821-1628

Publication Date September 30, 2018
Acceptance Date September 4, 2018
Published in Issue Year 2018 Volume: 8 Issue: 3

Cite

APA Esen, M., & Irmak Sapmaz, H. (2018). Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. Çağdaş Tıp Dergisi, 8(3), 211-217. https://doi.org/10.16899/gopctd.454562
AMA Esen M, Irmak Sapmaz H. Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. J Contemp Med. September 2018;8(3):211-217. doi:10.16899/gopctd.454562
Chicago Esen, Mehmet, and Hilal Irmak Sapmaz. “Epidemiological Investigation of Traumatic Upper Extremity Fractures in Children Who Applied to Emergency Department”. Çağdaş Tıp Dergisi 8, no. 3 (September 2018): 211-17. https://doi.org/10.16899/gopctd.454562.
EndNote Esen M, Irmak Sapmaz H (September 1, 2018) Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. Çağdaş Tıp Dergisi 8 3 211–217.
IEEE M. Esen and H. Irmak Sapmaz, “Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department”, J Contemp Med, vol. 8, no. 3, pp. 211–217, 2018, doi: 10.16899/gopctd.454562.
ISNAD Esen, Mehmet - Irmak Sapmaz, Hilal. “Epidemiological Investigation of Traumatic Upper Extremity Fractures in Children Who Applied to Emergency Department”. Çağdaş Tıp Dergisi 8/3 (September 2018), 211-217. https://doi.org/10.16899/gopctd.454562.
JAMA Esen M, Irmak Sapmaz H. Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. J Contemp Med. 2018;8:211–217.
MLA Esen, Mehmet and Hilal Irmak Sapmaz. “Epidemiological Investigation of Traumatic Upper Extremity Fractures in Children Who Applied to Emergency Department”. Çağdaş Tıp Dergisi, vol. 8, no. 3, 2018, pp. 211-7, doi:10.16899/gopctd.454562.
Vancouver Esen M, Irmak Sapmaz H. Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. J Contemp Med. 2018;8(3):211-7.