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

Rosendahl, Karen; Myklebust, Ramona; Ulriksen, Kjersti Foros; Nøttveit, Andreas; Eide, Pernille; Djuve, Åsmund; Brudvik, Christina

doi:10.1186/s12891-021-04420-4

Cited by 10 publications

(18 citation statements)

References 23 publications

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“…Of the 12 included studies, 7 were based on review of medical records; of which 5 were single hospital studies [ 1 , 2 , 11 – 13 ], 1 was based on medical records from two paediatric trauma units [ 12 ] and 1 on data from 27 hospitals and 126 clinics [ 14 ]. Five were registry studies [ 15 – 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two were prospective [ 12 , 13 ], 5 were retrospective cohort studies [ 1 , 2 , 11 , 14 , 20 ], and 5 were retrospective registry studies. In 3 of the studies, all radiographs were re-assessed by a radiologist or by an orthopaedic surgeon to minimize misdiagnosis [ 2 , 13 , 20 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…In children under the age of two, fractures are rare, particularly in non-ambulatory infants, with a predilection for the clavicle and skull in those under 8 months of age [ 1 ]. In toddlers between 9 and 24 months of age, forearm and lower leg fractures predominate [ 1 , 2 ]. The incidence and pattern of fractures in children under the age of two is, however, poorly described in the literature.…”

Section: Introductionmentioning

confidence: 99%

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The incidence of fractures in children under two years of age: a systematic review

Rosendahl,

de Horatio,

Habre

et al. 2024

BMC Musculoskelet Disord

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Background Epidemiological research on fractures in children under the age of two is of great importance to help understand differences between accidental and abusive trauma. Objective This systematic review aimed to evaluate studies reporting on the incidence of fractures in children under two years of age, excluding birth injuries. Secondary outcome measures included fracture location, mechanisms of injury and fracture characteristics. Methods A systematic literature review (1946 to February 7th 2024), including prospective and retrospective cohort studies and cross-sectional cohort studies, was performed. Studies including children from other age groups were included if the actual measures for those aged 0–2 years could be extracted. We also included studies restricted to infants. Annual incidence rates of fractures were extracted and reported as the main result. Critical appraisal of was performed using the Appraisal tool for Cross-Sectional Studies. Results Twelve moderate to good quality studies met eligibility criteria, of which seven were based on data from medical records and five were registry studies. Studies investigated different aspects of fractures, making comprehensive synthesis challenging. There was an overall annual fracture incidence rate of 5.3 to 9.5 per 1,000 children from 0–2 years of age; with commonest sites being the radius/ulna (25.2–40.0%), followed by tibia/fibula (17.3–27.6%) and the clavicle (14.6–14.8%) (location based on 3 studies with a total of 407 patients). In infants, the reported incidence ranged between 0.7 to 4.6 per 1,000 (based on 3 studies), with involvement of the clavicle in 22.2% and the distal humerus in 22.2% of cases (based on 1 study). Only a single metaphyseal lesion was reported (proximal humerus of an 11-month-old infant). Fracture mechanisms were detailed in four studies, with fall from chair, bed, table, own height or fall following indoor activities causing 50–60% of fractures. Conclusions There is a paucity of good quality data on fracture incidence in children under the age of two. Larger, prospective and unbiased studies would be helpful in determining normal pattern of injuries, so that differences from abusive trauma may be better understood.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The incidence of fractures in children under two years of age: a systematic review

Rosendahl,

de Horatio,

Habre

et al. 2024

BMC Musculoskelet Disord

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“…Quanto à incidência por gênero, observou-se que, na maioria dos estudos analisados, As maiores diferenças foram vistas em estudos que investigaram fraturas por colisões 10 , numa razão de 5,4 entre homens e mulheres; quedas, com razão de 2,9 meninos para cada menina e acidentes veiculares 32 , com razão de 2,11 meninos para cada menina. A maior proporção de homens, independente das etiologias analisadas, provavelmente se deve a comportamentos de risco por parte da população masculina, bem como a diferenças na socialização de pessoas desse gênero e à maior proporção de homens em esportes de contato/colisão 27,28 .…”

Section: -Gênerounclassified

Perfil Epidemiológico De Fraturas Ósseas Na Infância: Uma Revisão Integrativa Da Literatura

Gomes Costa Neves,

Lima de Oliveira,

Ferreira da Silva

et al. 2024

Inova

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Fraturas ósseas pediátricas são um problema de saúde pública. Logo, é crucial entender suas características epidemiológicas, os fatores de risco para sua ocorrência e o que influencia em sua incidência, incluindo a pandemia de COVID-19. Este estudo revisou artigos publicados entre março de 2017 e março de 2022 nas bases de dados PubMed, SciELO, Biblioteca Virtual em Saúde, Scopus e Web of Science e os selecionou com base em critérios de elegibilidade e exclusão pré-estabelecidos. Os resultados mostraram incidências variadas de fraturas, que aumentaram progressivamente com a idade e relacionaram-se a acidentes de trânsito e domésticos, violência, esportes, abuso infantil e adversidades de nascimento. Evidenciou-se que as fraturas são mais comuns em meninos e nos membros superiores. Fatores de risco incluem complicações de parto, uso de álcool e tabaco na gestação, carência de vitamina D e histórico familiar de fraturas. Durante a pandemia, houve redução nas taxas de fratura e na idade de apresentação, com aumento de lesões em ambiente doméstico. Com isso, observa-se que os resultados traçam a epidemiologia global das fraturas pediátricas, além da influência dos diferentes contextos e fatores de risco, presentes desde o período pré-natal, de modo que seria favorável aliar intervenções no âmbito familiar e dos serviços de saúde para sua prevenção.

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“…Fractures occurring before 18 months, the usual age of walking, have different risk factors. 33,34 Measures such as body mass index and eGFR, which we included in our analyses, are…”

Section: Assessment Of Skeletal Outcomesmentioning

confidence: 99%

Skeletal Outcomes in Children and Young Adults with Glomerular Disease

Davies

Xiao

Razzaghi

et al. 2022

JASN

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BackgroundChildren with glomerular disease have unique risk factors for compromised bone health. Studies addressing skeletal complications in this population are lacking.MethodsThis retrospective cohort study utilized data from PEDSnet, a national network of pediatric health systems with standardized electronic health record data for more than 6.5 million patients from 2009 to 2021. Incidence rates (per 10,000 person-years) of fracture, slipped capital femoral epiphysis (SCFE), and avascular necrosis/osteonecrosis (AVN) in 4598 children and young adults with glomerular disease were compared with those among 553,624 general pediatric patients using Poisson regression analysis. The glomerular disease cohort was identified using a published computable phenotype. Inclusion criteria for the general pediatric cohort were two or more primary care visits 1 year or more apart between 1 and 21 years of age, one visit or more every 18 months if followed >3 years, and no chronic progressive conditions defined by the Pediatric Medical Complexity Algorithm. Fracture, SCFE, and AVN were identified using SNOMED-CT diagnosis codes; fracture required an associated x-ray or splinting/casting procedure within 48 hours.ResultsWe found a higher risk of fracture for the glomerular disease cohort compared with the general pediatric cohort in girls only (incidence rate ratio [IRR], 1.6; 95% CI, 1.3 to 1.9). Hip/femur and vertebral fracture risk were increased in the glomerular disease cohort: adjusted IRR was 2.2 (95% CI, 1.3 to 3.7) and 5 (95% CI, 3.2 to 7.6), respectively. For SCFE, the adjusted IRR was 3.4 (95% CI, 1.9 to 5.9). For AVN, the adjusted IRR was 56.2 (95% CI, 40.7 to 77.5).ConclusionsChildren and young adults with glomerular disease have significantly higher burden of skeletal complications than the general pediatric population.

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

Cited by 10 publications

References 23 publications

The incidence of fractures in children under two years of age: a systematic review

The incidence of fractures in children under two years of age: a systematic review

Perfil Epidemiológico De Fraturas Ósseas Na Infância: Uma Revisão Integrativa Da Literatura

Skeletal Outcomes in Children and Young Adults with Glomerular Disease

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