Characteristics and Outcome of Paediatric Long Bone Fractures Managed in a University Teaching Hospital

I C Elachi,J N Kortor,R O Abah,W T Yongu,D D Mue

doi:10.46912/jbrcp.51

Abstract

Fractures constitute a significant component of paediatric trauma. Paediatric fractures account for significant morbidity. This study was set to elucidate the characteristics and outcome of paediatric fractures in a university teaching hospital. Case notes were reviewed for socio-demographic and clinical variables. Statistical analysis was carried out using the software Statistical Package for Social Sciences for Windows, Version 21.0. The correlation between development of complications and prior treatment by traditional bone setters was determined using chi-squared tests. Fifty four long bone fractures were studied in 52 children. Their ages ranged from 1 day to 16 years with a mean of 8.85 ± 3.86 years. There were 29 males (55.8%) and 23 females (44.2%). The aetiology of childhood fractures included road traffic crashes (n=30, 57.7%), falls (n=10, 19.3%), sports injuries (n=8, 15.4). The long bones fractured were tibia (n=19, 35.2%), femur (n=14, 25.9%), distal radius (n=14, 25.9%) and supracondylar part of the humerus (n=7, 13.0%). Non-operative treatment modalities were the most frequent means employed in treating children with fractures in this study. Limb gangrene following prior treatment by traditional bone setters was the most common complication. There was a statistically significant correlation between development of complications and prior traditional bone setters treatment (p<0.001). Paediatric fractures were more common in boys, caused mostly by road traffic crashes. Most were patients discharged without deformities. Public enlightenment on trauma prevention, enforcement of school bus transport system and reducing street hawking by expanding school feeding programmes may help reduce incidence of paediatric fractures.

Highlights

Trauma is an important cause of childhood morbidity and mortality globally.[1, 2] About 5 million children die from trauma each year.[3]
Most children involved in traffic-related injuries are usually pedestrians and passengers; child pedestrian injury rates have been found to be highest in Africa and Asia because many children walk to school.[11]
Among the road traffic-related victims, majority (n=24, 80.0%) were unguarded children hit by vehicles while crossing streets. (Table 1) The tibia was the most commonly fractured long bone in the study (n=19, 35.2%)

Summary

Introduction

Trauma is an important cause of childhood morbidity and mortality globally.[1, 2] About 5 million children die from trauma each year.[3] Fractures are a common occurrence in childhood constituting about 10 to 25 % of all paediatric injuries.[4] The lifetime risk of sustaining a fracture in childhood is approximately 42-. While falls in and around the home account for most paediatric fractures in western countries, fractures from road traffic crashes predominate in Nigeria.[6,7,8,9] In many low-income and middle-income countries, children are prone to road traffic crashes (RTC) because the road is a shared space for playing, working, walking, cycling and driving.[10] Most children involved in traffic-related injuries are usually pedestrians and passengers; child pedestrian injury rates have been found to be highest in Africa and Asia because many children walk to school.[11]

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Conclusion