Loder Randall T, O'Donnell Patrick W, Feinberg Judy R
Department of Orthopaedic Surgery, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
J Pediatr Orthop. 2006 Sep-Oct;26(5):561-6. doi: 10.1097/01.bpo.0000230335.19029.ab.
The most common pediatric orthopaedic injury requiring hospitalization is a femur fracture. This study aimed to identify the epidemiology and mechanisms of injury so that these injuries might be reduced through specifically targeted safety measures. Data for this study were culled from the 2000 Kids' Inpatient Database representing over 2.5 million pediatric hospital discharges. Of the nearly 10,000 femur fractures, 1076 (11%) occurred in children younger than 2 years; 2119 (21%) in children aged 2 to 5 years; 3237 (33%) in children aged 6 to 12 years; and 3528 (35%) in adolescents aged 13 to 18 years. The most (71%) occurred in male patients. Falls and motor vehicle collisions accounted for two thirds of those injuries, with the incidence of falls greater in the younger children and motor vehicle collisions more prevalent in older children. Fifteen percent of femoral fractures in children younger than 2 years were because of child abuse. Length of hospital stay, number of diagnoses and procedures, and hospital charges were greatest in the adolescent age group, likely because of high-energy trauma with resultant polytrauma. Hospital charges were more than 222 million dollars with the average charge over 2.5 times that in adolescents compared with infants/toddlers. Pediatric orthopaedists must continue to press for increased safety for our children, particularly adolescent motor vehicle safety. Abuse should be considered when a child younger than 2 years presents with a femoral fracture.
最常见的需要住院治疗的小儿骨科损伤是股骨骨折。本研究旨在确定损伤的流行病学特征和机制，以便通过针对性的安全措施来减少这些损伤。本研究的数据取自2000年儿童住院数据库，该数据库涵盖了超过250万例儿科住院病例。在近10000例股骨骨折病例中，1076例（11%）发生在2岁以下儿童；2119例（21%）发生在2至5岁儿童；3237例（33%）发生在6至12岁儿童；3528例（35%）发生在13至18岁青少年。其中大多数（71%）发生在男性患者中。跌倒和机动车碰撞占这些损伤的三分之二，年幼儿童中跌倒的发生率更高，而年龄较大儿童中机动车碰撞更为普遍。2岁以下儿童的股骨骨折中有15%是由于虐待儿童所致。青少年年龄组的住院时间、诊断和手术数量以及住院费用最高，这可能是由于高能创伤导致多发伤。住院费用超过2.22亿美元，青少年的平均费用是婴儿/幼儿的2.5倍多。小儿骨科医生必须继续努力为我们的儿童提高安全性，特别是青少年机动车安全。当2岁以下儿童出现股骨骨折时，应考虑虐待因素。
