Limb fractures in a defined population. I. Frequency and distribution

This population-based study revealed that 2,519 limb fractures occurring during a 3-year period produced an age-adjusted incidence rate for all limb fractures of 1,596 per 100,000 person-years. Fractures of the upper limb had a bimodal age distribution and were commoner than those of the lower limb, which had a J-shaped age distribution. The most frequent anatomic site was the lower end of the radius and ulna. Limb fractures occurred as solitary events in 93% of cases; only 4% were classified as open and more than half of the total were closed and undisplaced. Fractures were distributed evenly throughout all time periods of the day. The commonest place of fracture occurrence was the home, and the most important direct cause was falls, particularly in females. A wide range of sports activities were a major source of fractures, particularly in younger males. Underlying bone pathology was uncommon, other contributory causes being more important, particularly in the elderly. The increased ratio of metaphyseal to diaphyseal fractures with age indicated a relative loss of cancellous bone in the elderly, but no evidence was found to suggest that elderly women had reduced resistance of bone to impact forces in comparison with elderly men.

Injury patterns in motorcycle accidents

A retrospective study of 260 cases of motorcycle accidents which occurred over a 4 1/2 year period is reported. Approximately 8% died of their injuries. The vulnerability of the tibia to open fractures is noted, and the frequent association of these open injuries with severe contamination and devitalization of tissues resulting in a high complication rate. Severely comminuted intraarticular fractures of the distal tibia and radius were numerous, and one is tempted to name the injury the "motorcycle radius." Traumatic amputations were few and all involved the lower extremity. Fractures of the cervical and thoracic spine numbered only one each, but in each instance severe neurologic sequelae ensued. A plea is made for more accident prevention measures including protective equipment and driver education specific for the motorcyclist.

[Skateboard injuries (author's transl)]

Following the introduction of skateboards into Germany in 1976 an increasing number of accidents and injuries have been noted, affecting mainly children 10 to 14 years of age. The causes were lack of experience and the careless use of the boards on public streets. More than 30% of injuries were fractures mainly affecting the upper limb. Because of the frequent involvement of the epiphyseal plates the post-accidental growth may be seriously disturbed. Severe and sometimes fatal head or abdominal injuries have been reported, mainly after collision with cars.

[Fatigue fractures of the calcaneus in soldiers of the Federal Forces]

Fatigue fractures of the calcaneus occur more frequently today than the typical march fractures of the metatarsal bones. The cause lies in the altered method of training with repeated jumping exercises and increased strain on the calcaneus. 203 fatigue fractures of the calcaneus were seen in 5 years, almost exclusively in recruits in the first 3 months of enlistment. 10 day after the beginning of pain in the calcaneus and swellings--in half of them bilateral-the X-ray showed typical zones of densification in the calcaneus. The treatment consists of decompression for 2 weeks until the complaint disappears.