Section of Orthopedics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Eur J Trauma Emerg Surg. 2023 Apr;49(2):911-919. doi: 10.1007/s00068-022-02157-w. Epub 2022 Nov 5.
Pediatric tibial fractures have been described internationally as mainly caused by fall during leisure activities and organized sports and showing a higher incidence in boys. Still, most studies are single center studies or have a small sample size. This study aimed to analyze sex and age distribution, seasonal variation, injury mechanisms and treatment of pediatric tibial fractures based on the nationwide Swedish Fracture Register (SFR).
All tibial fractures in patients < 16 years at injury and registered in 2015-2019 were extracted from the SFR. We analyzed patient characteristics such as sex and age, injury mechanism, fracture location and treatment.
The study cohort consisted of 5828 pediatric tibial fractures in 5719 patients. Median age of the patients was 7 years and 58% were boys. Shaft fractures were most common, followed by the distal and proximal tibia. The lowest incidence was observed during autumn. The most common cause of injury was fall mostly involving winter sports, stumbles and fall from play equipment. Play/free time and sports were the most common activities, common places of injury were sports facility and home. 1% were open fractures. 78% were treated non-surgically. Screw fixation was performed in 52% of surgically treated fractures, predominantly in the distal segment.
Injury mechanism differs between age groups; play/free time injuries are common in younger children compared with sport activities in older children. Most patients are treated non-surgically. Open fractures are rare. Information on injury patterns is useful working preventively, for example safety work in playgrounds.
国际上已经描述了小儿胫骨骨折主要由休闲活动和有组织的运动中的跌倒引起，且男孩发病率更高。尽管如此，大多数研究都是单中心研究或样本量较小。本研究旨在基于全国性的瑞典骨折登记处（SFR）分析小儿胫骨骨折的性别和年龄分布、季节性变化、损伤机制和治疗方法。
从 SFR 中提取 2015-2019 年受伤时年龄<16 岁的所有胫骨骨折患者。我们分析了患者特征，如性别和年龄、损伤机制、骨折部位和治疗方法。
研究队列包括 5719 名患者的 5828 例小儿胫骨骨折。患者的中位年龄为 7 岁，58%为男孩。骨干骨折最常见，其次是胫骨远端和近端。秋季发病率最低。最常见的损伤原因是跌倒，主要涉及冬季运动、绊倒和从游乐设备上跌落。玩耍/自由时间和运动是最常见的活动，受伤的常见地点是运动设施和家庭。1%为开放性骨折。78%采用非手术治疗。78%的手术治疗骨折采用螺钉固定，主要在远端。
损伤机制在不同年龄组之间存在差异；与大龄儿童的运动活动相比，玩耍/自由时间受伤在年幼儿童中更为常见。大多数患者采用非手术治疗。开放性骨折很少见。损伤模式的信息对于预防性工作很有用，例如在游乐场的安全工作。
