Umraniye Training and Research Hospital, Department of Orthopedics and Traumatology, Istanbul.
Health Sciences University, Faculty of Medicine, Ankara Oncology Training and Research Hospital.
J Pediatr Orthop B. 2024 Sep 1;33(5):443-451. doi: 10.1097/BPB.0000000000001127. Epub 2023 Sep 7.
We evaluate the epidemiology and incidence of pediatric proximal femur fractures, treatment trends among different hospital levels, and complication rates among different treatment modalities by examining a national health registry in Türkiye. The health records of individuals aged ≤16 years admitted to public, private, and university hospitals were collected via the e-health database of the Turkish Ministry of Health. A total of 2388 children treated for proximal femur fractures from 2016 to 2021 with at least 2 years of follow-up were included in the study. While 2033 (85.1%) patients were treated with closed reduction and spica casts, 355 (14.8%) were operated on. Mean age was 8.603 ± 5.11 years. Male incidence was 2-fold greater compared to female patients (36.4% female and 63.6% male patients; P < 0.001). The frequency of cases was significantly increased in the age groups of 3-4 and 13-16 years. Comorbidities causing limited ambulation were detected in 6.5% of all cases, and 163 (8.0%) patients in the conservative group and 98 (27.6%) patients in the surgery group had at least one complication. The incidence was 0.45 per 100 000 children aged ≤16 years. This study reports the largest patient cohort to date, providing evidence on the epidemiology and incidence of pediatric proximal femur fractures using health registry data. We have found that the most common treatment modality for proximal femur fractures is closed reduction with spica casts. The rate of avascular necrosis is similar among patients treated surgically and those treated conservatively.
我们通过检查土耳其的国家健康登记处,评估了儿科股骨近端骨折的流行病学和发生率、不同医院级别的治疗趋势以及不同治疗方式的并发症发生率。通过土耳其卫生部的电子健康数据库收集了在公立、私立和大学医院就诊的≤16 岁的个体的健康记录。共有 2388 名接受股骨近端骨折治疗的儿童(2016 年至 2021 年,至少随访 2 年)被纳入研究。2033 名(85.1%)患者接受闭合复位和皮肤牵引治疗,355 名(14.8%)患者接受手术治疗。平均年龄为 8.603±5.11 岁。男性发病率是女性的两倍(女性患者占 36.4%,男性患者占 63.6%;P<0.001)。3-4 岁和 13-16 岁年龄段的病例频率显著增加。所有病例中,6.5%的病例存在导致活动受限的合并症,在保守治疗组中,163 名(8.0%)患者和手术组中 98 名(27.6%)患者至少有一处并发症。发病率为每 100000 名≤16 岁儿童 0.45 例。本研究报告了迄今为止最大的患者队列,使用健康登记处数据提供了关于儿科股骨近端骨折的流行病学和发生率的证据。我们发现,股骨近端骨折最常见的治疗方法是闭合复位加皮肤牵引。手术治疗和保守治疗的患者的股骨头坏死发生率相似。