Incidence patterns of traumatic upper limb fractures in children and adolescents

Abstract

China's child population ranked second in the world. However, data on the overall patterns and epidemiologic trends of TULFs among children and adolescents in Chongqing, China are scarce. With development of urbanization, motorization, building industry, the incidence patterns of traumatic upper limb fractures in children and adolescents might be about to change. To investigate the incidence patterns of traumatic upper limb fractures in children and adolescents (≤18 years old) according to age (≤3 years old, 3–6 years old, 6–12 years old, and 12–18 years old), gender, time, and etiology groups in Chongqing, China, we retrospectively reviewed 1078 children and adolescents who had traumatic upper limb fractures and who came to our university-affiliated hospitals from 2001 to 2010. The patients were grouped into different age groups, genders, year of admission range groups, and aetiologies. We used Pearson chi-square tests and independent samples t tests to assess differences of the grouped data and continuous variables, respectively. This study enrolled 1078 patients (849 males, 229 females) aged 11.0 ± 4.7 years old. The most common aetiologies and fracture sites of patients were low falls (705, 65.4%) and humerus (492, 45.6%). A total of 146 (13.5%) patients suffered a nerve injury, 94 (8.7%) patients sustained associated injuries, and 106 (9.8%) patients sustained complications. The proportion of injuries due to motor vehicle collisions increased with increasing age and year of admission. Female patients presented with significantly higher proportion of injuries due to motor vehicle collisions and significantly lower proportion of injuries due to hit by others. The proportion decreased from 63.2% to 33.3% in humeral fracture, increased from 8.8% to 35.5% in radius fracture, increased from 7.4% to 28.9% in ulna fracture with increasing age. Female patients presented with significantly higher proportion of humeral fracture, clavicle fracture and significantly lower proportion of radius fracture, ulna fracture, and hand fracture. Low falls and humerus fractures were the most common aetiologies and fracture sites. The pattern of traumatic upper limb fractures has specific age, gender, time, and etiology differences.