Abstract
BackgroundChildren and adolescents are at high risk of sustaining fractures during growth. Therefore, epidemiological assessment is crucial for fracture prevention. The AO Comprehensive Injury Automatic Classifier (AO COIAC) was used to evaluate epidemiological data of pediatric long bone fractures in a large cohort.MethodsData from children and adolescents with long bone fractures sustained between 2009 and 2011, treated at either of two tertiary pediatric surgery hospitals in Switzerland, were retrospectively collected. Fractures were classified according to the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).Age, sex, BMI, injury and treatment data were recorded. Children were classified into four age classes and five BMI classes were applied. Seven major accident categories were established. Study parameters were tabulated using standard descriptive statistics. The relationship of categorical variables was tested using the chi-square test. The Children’s BMI was compared to WHO reference data and Swiss population data.ResultsFor a total of 2716 patients (60% boys), 2807 accidents with 2840 long bone fractures (59% radius/ulna; 21% humerus; 15% tibia/fibula; 5% femur) were documented. Children’s mean age (SD) was 8.2 (4.0) years (6% infants; 26% preschool children; 40% school children; 28% adolescents). Adolescent boys sustained more fractures than girls (p < 0.001). The leading cause of fractures was falls (27%), followed by accidents occurring during leisure activities (25%), at home (14%), on playgrounds (11%), and traffic (11%) and school accidents (8%). There was boy predominance for all accident types except for playground and at home accidents. The distribution of accident types differed according to age classes (p < 0.001). Twenty-six percent of patients were classed as overweight or obese — higher than data published by the WHO for the corresponding ages — with a higher proportion of overweight and obese boys than in the Swiss population (p < 0.0001).ConclusionOverall, differences in the fracture distribution were sex and age related. Overweight and obese patients seemed to be at increased risk of sustaining fractures. Our data give valuable input into future development of prevention strategies. The AO PCCF proved to be useful in epidemiological reporting and analysis of pediatric long bone fractures.
Highlights
Children and adolescents are at high risk of sustaining fractures during growth
In 2007, the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) [12] was developed and validated according to a 3-phase concept proposed by Audigé et al [13]
The initial two validation phases showed that the classification process based on radiographic assessment is reliable and accurate [14,15] and that the PCCF system can be considered clinically relevant by pediatric surgeons
Summary
Children and adolescents are at high risk of sustaining fractures during growth. The AO Comprehensive Injury Automatic Classifier (AO COIAC) was used to evaluate epidemiological data of pediatric long bone fractures in a large cohort. In 2007, the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) [12] was developed and validated according to a 3-phase concept proposed by Audigé et al [13]. The AO Comprehensive Injury Automatic Classifier (AO COIAC) software [16] was developed for testing in a clinical setting following the 3rd and final validation phase, with the purpose of fully documenting and evaluating pediatric long bone fractures, their causes, classification codes, treatments, occurrence of associated complications, and outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
