Abstract
BackgroundUnintentional injury is one of the top three causes of death for infants. However, the epidemiological studies of skeletal trauma and skull fractures in infants younger than 1 year were poorly understood in China. Therefore, our study aimed to examine accidental and emergency attendance in infants under 1 year. It also tried to determine the prevalence and severity of accident types in infants.MethodsA retrospective analysis was performed on the demographic characteristics of infants younger than 1 year with skeletal trauma and skull fractures who visited the Shenzhen Children’s Hospital from January 1, 2016 to December 31, 2019. Age, gender, fracture site and type, mechanism of injury, length of visit, length of hospital stay, hospitalization cost, and treatment methods were analyzed.ResultsA total number of 675 fractures in 664 infants were included, the median age was 187days (IQR,90-273days), including 394 males and 270 females. The top three fracture sites were the skull (430 sites, 63.70 %), long bones of the limbs (168 sites, 24.89 %), and clavicle (53 sites, 7.85 %). The top three causes of injury were locomotion injuries (256 cases, 38.55 %), falls or trips from low height (from beds, tables, chairs, etc.) (130 cases, 19.58 %), and birth injuries (97 cases, 14.61 %). The greatest amount of fractures occurred in children 1–28 days of life (d) reached a top of 101 cases, followed by 331–365 days, accounting for 15.21 and 10.24 %, respectively. The number of fractures reached a trough of 29 cases in the 29-60d group (4.37 %). And increased again to 65 cases in the 151-180d group (9.79 %). The proportion remained relatively constant at 9 % in the 181-210d group (9.19 %) and 211-240d group (9.64 %). The interval between injury and visiting our hospital was ≤ 72 h in 554 cases.ConclusionsSpecial attention should be given to the demographic characteristics of fractures in infants under 1 year of age, and appropriate outreach should be implemented. For example, health education should be provided to aid in the prevention especially for frequently occurring locomotion injuries, and prompt access to specialist medical care should be recommended for skull fractures, which are prone to delayed treatment. In addition, multidisciplinary collaboration should be implemented in trauma care, while also promoting the establishment of trauma centers in specialist children’s hospitals with a stronger capacity to treat pediatric trauma, and a regional system for pediatric trauma treatment.
Highlights
Unintentional injury is one of the top three causes of death for infants
Special attention should be given to the demographic characteristics of fractures in infants under 1 year of age, and appropriate outreach should be implemented
Health education should be provided to aid in the prevention especially for frequently occurring locomotion injuries, and prompt access to specialist medical care should be recommended for skull fractures, which are prone to delayed treatment
Summary
The epidemiological studies of skeletal trauma and skull fractures in infants younger than 1 year were poorly understood in China. Despite the active implementation of measures to prevent accidental childhood injuries, the overall incidence of fractures is increasing, with the literature reporting that fractures account for 8–25 % of all injuries in children per 1000 children annually [3, 4]. Only a handful of epidemiological studies have been conducted on skeletal trauma and skull fractures in infants younger than 1 year. The clinical data of infants younger than 1 year with skeletal trauma and skull fractures who were admitted to the Shenzhen Children’s Hospital were collected, and a comprehensive analysis was performed on their gender, age, type of fracture, and cause of injury. Our aim was to achieve a preliminary understanding of their epidemiological characteristics, so as to provide a basis for the scientific formulation of preventive and intervention measures, and the establishment of scientific norms for trauma care, thereby improving the standards of trauma care
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