Salonen A, Pajulo O, Lahdes-Vasama T, Välipakka J, Mattila V M
Department of Pediatric and Adolescent Surgery, Pediatric Clinics and Pediatric Research Center, Tampere University Hospital, Teiskontie 35, 33521 Tampere, Finland.
Department of Pediatric Surgery, Pediatric Clinics, Turku University Hospital, Turku, Finland.
J Child Orthop. 2013 Dec;7(6):559-64. doi: 10.1007/s11832-013-0529-0. Epub 2013 Sep 17.
Studies of pediatric and adolescent fractures in general report a significant increase in the incidence of upper-extremity fractures as well as in their surgical treatment. The aim of this study was to determine the trends of the incidence and treatment of distal humeral fractures in hospitalized 0- to 18-year-old patients in Finland.
The study included the entire pediatric and adolescent (<19 years) population in Finland during the 24-year period from 1 January 1987 to 31 December 2010. Data on hospitalized patients were obtained from the nationwide National Hospital Discharge Registry where information is collected from all hospital categories (private, public, and other). Surgical treatment was categorized into three groups; (1) reposition with casting; (2) reposition or reduction and osteosynthesis; (3) reposition or reduction and external-fixation and other fixation methods. Patients were classified into three groups according to age: 0-6 years, 7-13 years, and 14-18 years. Annual incidences were calculated using the annual mid-year population census obtained from the Official Statistics of Finland.
During the 24-year study period, there were a total of 12,590 hospitalizations with a main or secondary diagnosis of distal humeral fracture. In children aged 0-12 years the overall incidence of hospitalization increased 30 % during the 24-year study period, from 4.5 per 10,000 person-years in 1987 to 5.8 per 10,000 person-years in 2010. There were a total of 5,548 operations. During the study period, surgical treatment by repositioning or reduction with osteosynthesis due to a distal humeral fracture increased by fivefold in patients aged <6 years and by twofold in patients aged 7-12 years of age. The incidences of fracture and treatment in children older than 13 years did not change.
The incidence of distal humeral fractures and the incidence of repositioning with osteosynthesis increased remarkably in prepubertal children during the 24-year study period in Finland.
关于儿童和青少年骨折的研究总体上报告称，上肢骨折的发病率及其手术治疗显著增加。本研究的目的是确定芬兰0至18岁住院患者肱骨远端骨折的发病率和治疗趋势。
该研究纳入了1987年1月1日至2010年12月31日这24年期间芬兰全部儿童和青少年（<19岁）人群。住院患者的数据来自全国性的国家医院出院登记处，该登记处收集了所有医院类别（私立、公立和其他）的信息。手术治疗分为三组：（1）复位并石膏固定；（2）复位或复位加骨固定；（3）复位或复位加外固定及其他固定方法。患者按年龄分为三组：0至6岁、7至13岁和14至18岁。年度发病率使用从芬兰官方统计数据获得的年度年中人口普查数据计算得出。
在24年的研究期间，共有12590例主要或次要诊断为肱骨远端骨折的住院病例。在0至12岁儿童中，24年研究期间住院的总体发病率增加了30%，从1987年的每10000人年4.5例增至2010年的每10000人年5.8例。共有554例手术。在研究期间，因肱骨远端骨折进行复位或复位加骨固定的手术治疗在<6岁患者中增加了五倍，在7至12岁患者中增加了两倍。13岁以上儿童的骨折和治疗发病率没有变化。
在芬兰24年的研究期间，青春期前儿童肱骨远端骨折的发病率以及复位加骨固定的发病率显著增加。
