Trends in the U.S. Childhood Emergency Department Visits for Fall-Related Fractures, 2001–2015

Orces, Carlos H.; Orces, Jacques

doi:10.7759/cureus.11629

Cited by 10 publications

(8 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 97%

“…Additionally, off-balance falls may be more frequent, resulting in young gymnasts reaching out with their arms to brace themselves, which may predispose them to upper extremity injuries. 22 These injuries may be traumatic and require ED presentation, which may further explain their relative rates in these studies as compared with those examining older gymnasts. Some studies have reported a sex-specific component to injury location, isolating the most common injury in male gymnasts to be to the upper extremity, particularly the wrist and hand.…”

Section: Discussionmentioning

confidence: 97%

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Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Tisano

Zynda

Ellis

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Despite increasing participation rates in youth gymnastics, the majority of epidemiologic literature focuses on older elite athletes or stratifies athletes by level of competition. Hypothesis: The authors hypothesized that sex- and age-based patterns in youth gymnastics–related injuries exist, which are otherwise overlooked in an unstratified population. Study Design: Descriptive epidemiology study. Methods: Publicly available injury data from the National Electronic Injury Surveillance System were collected on pediatric gymnastics injuries presenting to emergency departments in the United States. Participation data from the National Sporting Goods Association were used to calculate national injury incidence rates in 7- to 11-year-olds (childhood) and 12- to 17-year-olds (adolescence) from January 1, 2012, to December 31, 2018. Z tests were conducted for the comparison of injury rates between girls and boys within each age group and for overall injury rate across age groups. Results: Girls participated in gymnastics at a frequency 6.5 times that of boys in childhood and 13.5 times that of boys in adolescence. An estimated 72,542 youth gymnastics–related injuries were reported in US emergency departments each year. A large proportion (61.3%) occurred in childhood, with female predominance in both age groups. Overall, there was no difference in weighted annual injury rate (injuries per 100,000 athlete-days per year) by age group (6.9 [childhood] vs 8.8 [adolescence]; P = .19) or sex (7.4 [girls] vs 8.1 [boys]; P = .65). In adolescence, boys were more likely than girls to experience injury (16.47 vs 8.2; P = .003). Wrist and lower arm fractures were more common in childhood than adolescence (1.07 vs 0.43; P = .002) and specifically in girls (childhood vs adolescence, 1.06 vs 0.37; P = .001). Ankle injuries and concussions were more common in adolescence vs childhood ( P = .01 and .0002). Conclusion: Upper extremity injuries predominated among childhood gymnasts, particularly girls. In adolescence, girls and boys experienced increases in concussions and foot and ankle injuries. Although representing a lower overall number of training gymnasts as compared with girls, adolescent boys experience a higher rate of injuries overall.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Tisano

Zynda

Ellis

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Fractures in children are a common presentation to the emergency department, with overall estimated annual incidence rates of 1500-3600 fractures per 100 000 children per year. [1][2][3][4][5] Fractures in childhood cause pain and loss of opportunity. [6][7][8] Most children contained within these series are managed in the community.…”

Section: Introductionmentioning

confidence: 99%

Trends in hospital admissions for childhood fractures in England

Marson

Manning

James

et al. 2021

bmjpo

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PurposeFractures to the axial and appendicular skeleton are common in children causing loss of opportunities and disability. There are relatively few studies available to quantify the number of children who have their fractures diagnosed in the emergency department and are then admitted to hospital for ongoing management. The purpose of this study is to explore trends of frequency, types and age of children sustaining fractures who were admitted for intervention to National Health Service (NHS) hospitals.DesignThe study uses data from the Hospital Episode Statistics and Office for National Statistics from 2012 to 2019 to calculate the annual incidence of hospital admission for limb, spine, facial and skull fractures per 100 000 children.ResultsDuring 2012–2019, 368 120 children were admitted to English NHS hospitals with a fracture. 256 008 (69.5%) were upper limb fractures, 85 737 (23.3%) were lower limb fractures and 20 939 (5.7%) were skull or facial fractures. The annual incidence of upper limb fractures was highest in children aged 5–9 (348.3 per 100 000 children) and the highest incidence of lower limb fractures was in children aged 10–15 (126.5 per 100 000 children). The incidence of skull and facial fractures in preschool (age 0–4) children has been increasing at a rate of 0.629 per 100 000 children per year.ImplicationsThe annual incidence of hospital admission for fractures in children has been shown to be consistent for several fracture types between 2012 and 2019. An increasing trend of admissions with preschool skull fractures was observed, though the study data do not have sufficient granularity to demonstrate if this is due to changes in practice or to accidental or non-accidental causes.

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“…However, fracture incidence may be exposed to time trends, as studies from our region have identified higher age- and sex-adjusted hand fracture incidence 1976–1979 than 1950/1955, but similar incidences 1976–1979, 1993–1994, and 2005–2006 [ 5 ]. Studies from many settings report time trends: from Finland with lower pediatric hand fracture incidence in 2005 than in 1983 [ 4 ], from the USA with decreasing fall-related hand/finger fracture incidence between 2001 and 2015 [ 6 ], and from Denmark with lower incidence of metacarpal fractures in age groups 6–11 and 12–15 in 2015–2018 than in 1994–1999 [ 7 ]. Time trends may be different in different regions and during different periods but at least part of the differences may be due to methodological issues, such as different ascertainment methods, or that inferences are based on comparison between absolute incidences or age- and sex-adjusted incidences.…”

Section: Introductionmentioning

confidence: 99%

Time trends in pediatric hand fracture incidence in Malmö, Sweden, 1950–2016

et al. 2021

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Background The hand is the second most fractured region in children. It is therefore important to update fracture epidemiology to be able to identify time trends for adequate health care planning. This study reports pediatric hand fracture incidence 2014–2016 and, using published data, also long-term time trends in 1950–2016. Patients and methods The Swedish city of Malmö, with 328,494 inhabitants in 2016, has only one hospital. We used the hospital radiological archive, medical charts, and diagnosis registry to identify hand fractures in city residents < 16 years in 2014–2016. These data were compared to those from three published studies that evaluated periods in 1950–2006. Differences between two periods were calculated as both unadjusted and age- and sex-adjusted incident rate ratios (IRR) with 95% confidence intervals (95% CI). We used joinpoint regression to estimate time trends during the entire period and present annual percent changes (APC) with 95% CI. Results In 2014–2016 phalangeal fractures accounted for 71% of all hand fractures, metacarpal fractures for 24%, and carpal fractures for 5%. We identified 615 hand fractures (419 in boys and 196 in girls) during 181,617 person-years in 2014–2016, resulting in an unadjusted pediatric hand fracture incidence of 339/100,000 person-years (boys 452/100,000 person-years and girls 220/100,000 person-years). The age-adjusted incidence 2014–2016 was similar to 2005–2006, the most recently evaluated period (IRR in boys 0.9; 95% CI 0.8 to 1.01, and in girls 1.0; 95% CI 0.8 to 1.2). Looking at the entire period 1950–2016, we found that age-adjusted incidence increased in 1950–1979, in boys by APC + 3.8%; 95% CI 3.0 to 4.5 and in girls by + 3.9%; 95% CI 2.8 to 5.0, but decreased in 1979–2016, in boys by − 0.7%; 95% CI − 1.4 to − 0.003, and girls by − 1.3%; 95% CI − 2.4 to − 0.1. Conclusions Phalangeal fractures accounted for about three quarters of all hand fractures. The age-adjusted hand fracture incidence increased in both sexes in 1950–1979 and decreased in 1979–2016. Level of evidence III

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Trends in the U.S. Childhood Emergency Department Visits for Fall-Related Fractures, 2001–2015

Cited by 10 publications

References 18 publications

Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Trends in hospital admissions for childhood fractures in England

Time trends in pediatric hand fracture incidence in Malmö, Sweden, 1950–2016

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