Abstract
BackgroundFractures in children under 2 years of age are rare, and little has been published on their mechanisms. We aimed at examining the incidence, mechanisms, pattern and fracture characteristics in a large, population-based cohort of otherwise healthy children.MethodsThis retrospective, cross-sectional study includes all children aged 0–2 years, attending the Accident and Emergency department in Bergen between 2010 and 2015, due to an injury warranting radiography. Clinical data was categorized from the medical notes, and all radiographs were reviewed by an experienced paediatric radiologist.ResultsIn total 408 children (212 male), 3–23 months of age (mean 17.7 months), were included. 149 (77 male) children had a total of 162 fractures, yielding an annual incidence of 5.4 per 1000, varying from 0.7 per 1000 for those under 12 months of age, increasing tenfold to 7.3 per 1000 for children aged 12–24 months of age. More than half of the fractures (53.1%) were seen in children aged 18–23 months, while none was found in those under 7 months of age. The youngest age group had mostly femur and tibia fractures, the oldest mostly forearm fractures (n = 55, 33.9%), followed by tibia fractures (21.6%) and fractures to the clavicle (14.8%). The reported mechanisms for the 162 fractures were fall from a chair/bed/table (41.4%), fall from own height (18.5%) or crush injury (15.4%). In 8 of 162 (4.9%) fractures, the history was clearly inconsistent and suspicious of non-accidental injury (NAI).ConclusionInjuries and fractures in young children in general, and non-ambulant children in particular, are rare and should be thoroughly assessed for NAI. Level of evidence: Retrospective, population based cross-sectional study. Level 3.
Highlights
IntroductionThe annual incidence rates of fractures in children under 16 years varies from 3.6 per 1000 to 50 per 1000 according to age, gender, social and environmental factors, and typically peaks at 11–12 years for girls and 13–
The annual incidence rates of fractures in children under 16 years varies from 3.6 per 1000 to 50 per 1000 according to age, gender, social and environmental factors, and typically peaks at 11–12 years for girls and 13–Faculty of Health Sciences, Department of Clinical Medicine, UiT the ArcticUniversity of Norway, Tromsø, NorwaySection of Paediatric Radiology, University Hospital North Norway, Pb 100, Tromsø, NorwayFull list of author information is available at the end of the article years for boys [1,2,3,4,5]
Children had a total of 162 fractures, yielding an annual incidence of 5.4 per 1000, varying from 0.7 per 1000 for those under 12 months of age, increasing tenfold to 7.3 per 1000 for children aged 12–24 months of age
Summary
The annual incidence rates of fractures in children under 16 years varies from 3.6 per 1000 to 50 per 1000 according to age, gender, social and environmental factors, and typically peaks at 11–12 years for girls and 13–. Section of Paediatric Radiology, University Hospital North Norway, Pb 100, Tromsø, Norway. In children between 9 and 24 months of age, forearm, tibia and fibula fractures predominate [1]. In a population-based cohort of 408 children under 2 years of age, that 149 (77 boys) children had a total of 162 fractures, yielding a. Fractures in children under 2 years of age are rare, and little has been published on their mechanisms. We aimed at examining the incidence, mechanisms, pattern and fracture characteristics in a large, population-based cohort of otherwise healthy children
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