From the Department of Women, Mother, and Child's Health Care, Paediatric Surgery, Unit of Paediatric Orthopedic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Pediatr Emerg Care. 2021 Dec 1;37(12):e825-e835. doi: 10.1097/PEC.0000000000002047.
Fractures in children are common and account for 10% to 25% of injuries in children with considerable effects on activity restriction and subsequent high socioeconomically impact. Eighty percent of all fractures in children occur at the upper extremity. The article investigates the epidemiology and fracture pattern of the upper extremity within a pediatric population consulting a tertiary referral hospital in Switzerland.
Study population included all patients younger than 18 years presenting with an upper extremity fracture. Recorded data were age, sex, side, season of the year, mechanism, type of fracture, and applied treatment.
Fractures of the upper extremities represented 76% with a mean age of 9 years and 7 months. Compared with girls, boys had a risk ratio of 1.35 (1.14-1.6) of having a traumatic injury. The radius, with 298 fractures (37%), was the most injured bone. Overall simple fall from his or her height and soccer represented the main injury mechanisms accounting for 26% and 9%, respectively. Eighty-six percent of fractures were treated by cast with or without closed reduction, 11% (92) by closed reduction and pinning or elastic stable intramedullary, and only 3% of fractures were treated by open reduction and internal fixation.
Eighty-six percent of all fractures could be treated by conservative methods. Only 17% need surgical treatments by orthopedic surgeons. This shows how important it is to train residents in pediatrics for the treatment of upper limb fractures in children.
儿童骨折较为常见,占儿童损伤的 10%至 25%,对活动受限和随后的高社会经济影响有较大影响。80%的儿童骨折发生在上肢。本文研究了瑞士一家三级转诊医院儿科就诊的儿童上肢骨折的流行病学和骨折类型。
研究人群包括所有年龄小于 18 岁的上肢骨折患者。记录的数据包括年龄、性别、侧别、一年中的季节、机制、骨折类型和应用的治疗方法。
上肢骨折占 76%,平均年龄为 9 岁 7 个月。与女孩相比,男孩发生创伤性损伤的风险比为 1.35(1.14-1.6)。桡骨骨折 298 例(37%)最为常见。总体而言,从其高度简单跌倒和足球是主要的损伤机制,分别占 26%和 9%。86%的骨折采用石膏固定或不进行闭合复位治疗,11%(92 例)采用闭合复位和钢钉或弹性稳定髓内钉治疗,只有 3%的骨折采用切开复位和内固定治疗。
86%的骨折可以通过保守方法治疗。只有 17%的骨折需要骨科医生进行手术治疗。这表明对儿科住院医师进行上肢骨折治疗的培训非常重要。