Bridgman S, Wilson R
Epidemiology and Public Health Research Unit, School of Medicine, Faculty of Health, University of Keele, Keele, Staffordshire ST5 5BG, UK.
J Bone Joint Surg Br. 2004 Nov;86(8):1152-7. doi: 10.1302/0301-620x.86b8.14810.
We have attempted to describe the epidemiology of femoral fractures in children in the West Midlands region of the National Health Service in England. Our source of data was the Regional Hospital Episode Statistics database for the years 1991-2 to 2001-2. Cases were defined as emergency hospital admissions in patients aged under 16 years, with a diagnostic code of femoral fractures in any field, and resident in the West Midlands. Between 1991-2 and 2001-2, 3272 children aged under 16 years with femoral fractures were admitted to hospital. The crude incidence during this period decreased from 0.33 to 0.22 femoral fractures/1000/year. Those caused by traffic accidents decreased by 43%, and by falls by 29%. The peak age-gender-specific incidence (0.91/1000/year) was in two-year-old boys, and this was 50% higher than in the next highest age-gender group. In the first year of life, the incidence in boys and girls was the same. Thereafter the rate in boys exceeded that in girls, varying from 1.6 times at 11 years to 4.7 times at 14 years. Falls accounted for 49% of the fractures, varying from 77% in one-year-olds to 26% in eight-year-old children. Traffic accidents were responsible for 26% of fractures varying from 55% in ten-year-old to 2% in one-year-old children. Maltreatment was recorded in 1.3% of all cases, and in 8.5% of children under one year. Twice as many fractures were seen in May to August than in January (winter). The rates of fractures were associated with deprivation for all age-gender groups. Fractures of the shaft accounted for 58% of all fractures, varying from 70% in three-year-old to 34% in 13-year-old children. Our findings show that there has been a decrease in the incidence of femoral fractures during the 1990s and early 2000s. Two-year-old boys had twice the rate than any other single-year age-gender group. More deprived areas had much higher rates which suggests the potential for greater prevention. A relatively low rate of maltreatment was recorded compared with that in some other studies.
我们试图描述英格兰国民医疗服务体系西米德兰兹地区儿童股骨骨折的流行病学情况。我们的数据来源是1991 - 2年至2001 - 2年的地区医院事件统计数据库。病例定义为16岁以下患者的急诊入院，任何领域诊断代码为股骨骨折，且居住在西米德兰兹地区。1991 - 2年至2001 - 2年期间，3272名16岁以下股骨骨折儿童入院。在此期间，粗发病率从0.33降至0.22例股骨骨折/1000/年。交通事故导致的骨折减少了43%，跌倒导致的骨折减少了29%。年龄 - 性别特异性发病率峰值（0.91/1000/年）出现在两岁男孩中，比次高年龄 - 性别组高50%。在生命的第一年，男孩和女孩的发病率相同。此后，男孩的发病率超过女孩，从11岁时的1.6倍到14岁时的4.7倍不等。跌倒占骨折的49%，从一岁儿童的77%到八岁儿童的26%不等。交通事故导致26%的骨折，从十岁儿童的55%到一岁儿童的2%不等。所有病例中有1.3%记录为虐待，一岁以下儿童中有8.5%。5月至8月的骨折病例是1月（冬季）的两倍。所有年龄 - 性别组的骨折发生率都与贫困程度有关。股骨干骨折占所有骨折的58%，从三岁儿童的70%到13岁儿童的34%不等。我们的研究结果表明，在20世纪90年代和21世纪初，股骨骨折的发病率有所下降。两岁男孩的发病率是其他任何单一年龄 - 性别组的两倍。贫困地区的发病率要高得多，这表明有更大的预防潜力。与其他一些研究相比，记录的虐待发生率相对较低。
