de Putter C E, van Beeck E F, Looman C W N, Toet H, Hovius S E R, Selles R W
Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC Rotterdam, Rotterdam.
J Hand Surg Am. 2011 Nov;36(11):1810-1815.e2. doi: 10.1016/j.jhsa.2011.08.006.
Distal radius and carpal fractures in children and adolescents represent approximately 25% of all pediatric fractures. Incidence rates and causes of these fractures change over time owing to changes in activities and risk factors. The purpose of this study was to examine recent population-based trends in incidence and causes of wrist fractures in children and adolescents.
We obtained data from the Dutch Injury Surveillance System of emergency department visits of 15 geographically distributed hospitals, and from the National Hospital Discharge Registry. This included a representative sample of outpatients and inpatients, respectively. We calculated incidence rates of wrist fractures per 100,000 person-years for each year between 1997 and 2009. Using Poisson's regression, we analyzed trends for children and adolescents 5 to 9, 10 to 14, and 15 to 19 years of age separately for boys and girls.
During the study period, incidence rates increased significantly in boys and girls 5 to 9 and 10 to 14 years of age, with the strongest increase in the age group 10 to 14 years. The observed increases were mainly due to increased incidence rates during soccer and gymnastics at school.
This population-based study revealed a substantial sports-related increase in the incidence rate of wrist fractures in boys and girls aged 5 to 9 and 10 to 14 years in the period 1997 to 2009.
With knowledge of the epidemiology of wrist fractures, prevention programs can be improved. From this study, we know that the incidence rate of wrist fractures in childhood is increasing, mainly as a result of soccer and gymnastics at school. Future sport injury research and surveillance data are necessary to develop new prevention programs based on identifying and addressing specific risk factors, especially in young athletes.
儿童和青少年的桡骨远端及腕骨骨折约占所有儿童骨折的25%。由于活动和风险因素的变化,这些骨折的发病率和病因会随时间而改变。本研究的目的是调查儿童和青少年腕部骨折发病率及病因的近期人群趋势。
我们从荷兰伤害监测系统获取了15家分布于不同地理位置医院急诊科就诊的数据,以及国家医院出院登记处的数据。这分别包括了门诊患者和住院患者的代表性样本。我们计算了1997年至2009年每年每10万人年的腕部骨折发病率。使用泊松回归分析,我们分别对5至9岁、10至14岁以及15至19岁的儿童和青少年按性别分析了趋势。
在研究期间,5至9岁和10至14岁的男孩和女孩的发病率显著增加,其中10至14岁年龄组的增加最为明显。观察到的增加主要归因于学校足球和体操运动期间发病率的上升。
这项基于人群的研究显示,在1997年至2009年期间,5至9岁和10至14岁的男孩和女孩腕部骨折发病率因运动相关因素大幅上升。
了解腕部骨折的流行病学情况有助于改进预防方案。从本研究可知,儿童期腕部骨折的发病率在上升,主要是由于学校的足球和体操运动。未来需要运动损伤研究和监测数据,以基于识别和解决特定风险因素来制定新的预防方案,尤其是针对年轻运动员。