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01.12.2019 | Research article | Ausgabe 1/2019 Open Access

Journal of Orthopaedic Surgery and Research 1/2019

Hand fracture epidemiology and etiology in children—time trends in Malmö, Sweden, during six decades

Zeitschrift:
Journal of Orthopaedic Surgery and Research > Ausgabe 1/2019
Autoren:
Vasileios Lempesis, Björn E. Rosengren, Lennart Landin, Carl Johan Tiderius, Magnus K. Karlsson
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s13018-019-1248-0) contains supplementary material, which is available to authorized users.

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Abstract

Background

The aim of this study was to describe hand fracture epidemiology/etiology in city children and describe time trend during six decades.

Patients and methods

A single hospital serves the entire city population of 271,271 (year 2005). Through the hospital medical and radiological archives, we collected epidemiology and etiology data concerning pediatric (age < 16 years) hand fractures in city residents, treated during 2005–2006. We compared these data to previously collected data in in the same city during 12 evaluated periods from 1950/1955 to 1993–1994. We present period-specific crude and age- and gender-adjusted fracture incidence rates and group differences as incidence rate ratios (RR) with 95% confidence intervals (95% CI).

Results

In 2005–2006, we identified 414 hand fractures (303 in boys and 111 in girls), 247 phalangeal fractures (60% of all hand fractures), 140 metacarpal/carpal fractures (except the scaphoid bone) (34%), and 27 scaphoid fractures (6%). The crude hand fracture rate in children was 448/100,000 person years (639/100,000 in boys and 247/100,000 in girls), with a 2.5 times higher age-adjusted incidence in boys than in girls. Compared to 1950/1955, the age and gender-adjusted hand fracture incidence was twice as high in 2005–2006 and more than twice as high in 1976–1979. Compared to 1976–1979, we found no significant difference in the age and gender-adjusted hand fracture incidence in 2005–2006. In 2005–2006, sports injuries explained 42%, fights 20%, and traffic accidents 13% of the hand fractures. In 1950/1955, sports injuries explained 27% of fractures, fights 10%, and traffic accidents 21%.

Conclusions

The incidence of hand fractures in children was more than twice as high in the end of the 1970s compared to the 1950s, where after no significant change could be found. Also, fracture etiology has changed. New studies are needed, to adequately allocate health care resources and identify new fracture prone activities suitable for preventive measures.

Level of evidence

III
Zusatzmaterial
Additional file 7: Table S5. Differences in crude and age-adjusted incidence of fractures of the phalanges of the hand in children, in boys and in girls aged < 16, from 1950/1955 to 1976–1979 (previously only reported as crude changes [6]) and to 2005–2006 (changes from the first to the most recent evaluated period), from 1976/1979 to 1993/1994 (previously only reported as crude changes [9]) and to 2005–2006 (changes from the period with the highest reported fracture incidence [6] to the most recent evaluated period) and from 1993 to 1994 to 2005–2006 (changes from the last reported fracture incidence [9] to the most recent evaluated period). Comparisons are presented as Rate Ratios with 95% Confidence Intervals (95% CI) within brackets. Statistically significant changes are bolded. (DOCX 16 kb)
Additional file 8: Table S6. Differences in crude and age-adjusted incidence of fractures of the metacarpals/carpal bones (except the scaphoid bone) in children, in boys and in girls aged < 16. from 1950/1955 to 1976–1979 (previously only reported as crude changes [6]) and to 2005–2006 (changes from the first to the most recent evaluated period), from 1976/1979 to 1993/1994 (previously only reported as crude changes [9]) and to 2005–2006 (changes from the period with the highest reported fracture incidence [6] to the most recent evaluated period) and from 1993 to 1994 to 2005–2006 (changes from the last reported fracture incidence [9] to the most recent evaluated period). Comparisons are presented as Rate Ratios with 95% Confidence Intervals (95% CI) within brackets. Statistically significant changes are bolded. (DOCX 13 kb)
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