Pediatric femur fractures: A seven-year review

Abstract

Study objectives: We describe our experience with pediatric patients (aged 0 to 14 years) presenting to an urban Level I trauma center with a femur fracture. Methods: This was a retrospective review of all pediatric femur fractures collected during daily medical record reviews from 1997 to 2003. Data included age, sex, mechanism of injury, associated trauma, fracture type, and emergency d d epartment disposition. Results: Two hundred fifty-nine patients presented with femur fractures, and all records were available for review. One hundred three (40%) patients sustaining femur fracture were 5 to 9 years of age, followed by 98 (39%) in the 0- to 4-year-old age group. One hundred eighty-two (70%) were male patients. One hundred forty-three patients (55%) sustained isolated femur fracture. The majority of all femur fractures (246 or 95%) were closed fractures. The mechanisms of injury were divided into 7 broad categories: automobile versus pedestrian or bicycle 106 (41%), falls 52 (20%), motor vehicle crash 26 (10%), suspected child abuse 23 (9%), sport injuries 17 (7%), object fell on child 11 (4%) and gunshot wounds 5 (2%). In the 0- to 4-year-old age group, the major mechanism of injury was suspected child abuse, with the 0- to 12-month age group (64%) followed by 1-year-olds (30%). The 5-year-old age group sustained the highest number of automobile versus pedestrian or bicycle accidents (76%). In the 10- to 14-year-old age motor vehicle accident (57%). Two hundred forty-eight patients (97%) were admitted to the hospital, with 2 taken directly to the operating room and 1 death. Conclusion: The majority of pediatric femur fractures treated in this population were in the 5- to 9-year-old age group and resulted from being struck by an automobile, either as a pedestrian or on a bicycle. They sustained isolated, closed femur fractures. There were several interesting trends observed. All of the fractures caused by suspected child abuse were in the patients 4 years old and younger. Fractures caused by automobile versus pedestrian or bicycle began to peak in the 3-year-old age group and declined again in patients older than 10 years. Femur fractures caused by motor vehicle crash was uncommon until the age of 10 years. The majority of patients were admitted to the hospital. Study objectives: We describe our experience with pediatric patients (aged 0 to 14 years) presenting to an urban Level I trauma center with a femur fracture. Methods: This was a retrospective review of all pediatric femur fractures collected during daily medical record reviews from 1997 to 2003. Data included age, sex, mechanism of injury, associated trauma, fracture type, and emergency d d epartment disposition. Results: Two hundred fifty-nine patients presented with femur fractures, and all records were available for review. One hundred three (40%) patients sustaining femur fracture were 5 to 9 years of age, followed by 98 (39%) in the 0- to 4-year-old age group. One hundred eighty-two (70%) were male patients. One hundred forty-three patients (55%) sustained isolated femur fracture. The majority of all femur fractures (246 or 95%) were closed fractures. The mechanisms of injury were divided into 7 broad categories: automobile versus pedestrian or bicycle 106 (41%), falls 52 (20%), motor vehicle crash 26 (10%), suspected child abuse 23 (9%), sport injuries 17 (7%), object fell on child 11 (4%) and gunshot wounds 5 (2%). In the 0- to 4-year-old age group, the major mechanism of injury was suspected child abuse, with the 0- to 12-month age group (64%) followed by 1-year-olds (30%). The 5-year-old age group sustained the highest number of automobile versus pedestrian or bicycle accidents (76%). In the 10- to 14-year-old age motor vehicle accident (57%). Two hundred forty-eight patients (97%) were admitted to the hospital, with 2 taken directly to the operating room and 1 death. Conclusion: The majority of pediatric femur fractures treated in this population were in the 5- to 9-year-old age group and resulted from being struck by an automobile, either as a pedestrian or on a bicycle. They sustained isolated, closed femur fractures. There were several interesting trends observed. All of the fractures caused by suspected child abuse were in the patients 4 years old and younger. Fractures caused by automobile versus pedestrian or bicycle began to peak in the 3-year-old age group and declined again in patients older than 10 years. Femur fractures caused by motor vehicle crash was uncommon until the age of 10 years. The majority of patients were admitted to the hospital.