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Garcia-Rueda MF, Mendoza-Pulido C, Taborda-Aitken JC, Becerra G, Velasquez-Urrego JL, Rincón-Lozano JD, Caicedo-Gutierrez ML, Silva-Amaro AC, Lorza-Toquica LD, Rodriguez-Lopez JA, Salazar-Sierra JA, Saravia-Hoyos GA, Schuster-Wasserman JA, Valencia-Chamorro MP. Distribution of fractured bones among children: Experience with the Comprehensive Pediatric AO classification in a children's orthopedic hospital in Bogotá-Colombia. Injury 2023; 54 Suppl 6:110780. [PMID: 38143128 DOI: 10.1016/j.injury.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Fractures in children and adolescents are a public health issue. However, reliable epidemiological descriptions of the South American population must be improved. This study aims to present epidemiological data on fractures from a children's orthopedic hospital in one of the five largest cities in Latin America. PATIENTS AND METHODS Descriptive epidemiological data from 2015 to 2019 were used to characterize children's fractures. Demographic variables, the number of fractured bones, high-energy trauma findings, fracture characteristics, fingertip injuries, and associated complications discriminated by the type of treatment are presented. Long bone fractures were classified according to the AO classification. All children less than 18 years of age were included. RESULTS In a population of 3,616 children, 4,596 fractures were identified. More boys than girls sustain a fractured bone, with ratios as high as 6:1 around 15 years old. Distal forearm fractures were the most common (31.9%), followed by distal humerus (20.2%). Most of the complications were related to these two sites of fractures. The OR of complications between surgical and conservative management was 2.86. CONCLUSION Epidemiological data of fractures from the authors' institution display the usual trending reported in most populations. Gender-related and age-related differences were relevant. Most fractures and complications are related to upper limb low-energy trauma. The most frequent are loss of ROM and loss of reduction. LEVEL OF EVIDENCE Level III - retrospective cohort study.
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Affiliation(s)
| | - Camilo Mendoza-Pulido
- School of Medicine, Department of Physical Medicine and Rehabilitation, Universidad Nacional de Colombia, Carrera 45 #26-85, Bogotá, Colombia
| | - Juan Carlos Taborda-Aitken
- School of Medicine, Department Orthopedics and Traumatology, Universidad Javeriana, Carrera 7 #40-62, Bogotá, Colombia
| | - Gustavo Becerra
- School of Medicine, Universidad Militar Nueva Granada, Carrera 11 #101-80 Bogotá, Colombia
| | | | - Julián David Rincón-Lozano
- Department of Orthopedics and Traumatology, Instituto Roosevelt, Carrera 4 east #17-50, Bogotá, Colombia
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Lotan R, Thein R, Gordon B, Tenenbaum S, Derazne E, Tzur D, Afek A, Hershkovich O. Is There an Association between BMI, Height, and Gender and Long-Bone Fractures during Childhood and Adolescence? A Large Cross-Sectional Population Study of 911,206 Subjects. CHILDREN (BASEL, SWITZERLAND) 2023; 10:984. [PMID: 37371216 DOI: 10.3390/children10060984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
INTRODUCTION Traumatic long-bone fractures (TLFs) among children and adolescents are relatively common, with morbidity and economic consequences. Obesity has become a significant global concern. Studies have found an association between TLFs and BMI in the past but not in a large cross-sectional population study. Our study objective was to measure the incidence of TLFs in the 17-year-old general population and evaluate its association with BMI, body height, and gender. METHODS Data from a medical database containing all 17-year-old candidates' records before recruitment into mandatory military service were retrieved as BMI, height, gender, and history of TLFs. Logistic regression models assessed the association between BMI and height to TLFs. RESULTS The records of 911,206 subjects (515,339 males) were reviewed. In total, 9.65% had a history of TLFs (12.25% and 6.25% for males/females, respectively). Higher BMI was associated with TLF, with a linear trend in the odds ratio (OR) for having TLFs. The strongest association was found between obese females and TLFs (OR = 1.364, p < 0.0001). Height was an independent factor positively associated with TLFs. The OR for a TLF in the highest height quintile was 1.238 (p < 0.001) for males and 1.411 (p < 0.001) for females compared to the lowest quintile. Although TLFs were more common in males, the OR for TLFs was more prominent in females. CONCLUSIONS There is an association between BMI, body height, and TLFs in healthy adolescents. TLFs are more common in males, but the strongest association between overweight and obesity is evident in females.
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Affiliation(s)
- Raphael Lotan
- Department of Orthopedic Surgery, Edith Wolfson Medical Center, Affiliated to the Sackler School of Medicine, Holon 5822012, Israel
| | - Ran Thein
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv 5262000, Israel
| | - Barak Gordon
- Medical Corps, Israeli Defense Forces, Ramat Gan 91120, Israel
- Department of Military Medicine, Faculty of Medicine, Institute for Research in Military Medicine (IRMM), The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv 5262000, Israel
| | - Estela Derazne
- Medical Corps, Israeli Defense Forces, Ramat Gan 91120, Israel
| | - Dorit Tzur
- Medical Corps, Israeli Defense Forces, Ramat Gan 91120, Israel
| | - Arnon Afek
- Management, Chaim Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv 5262000, Israel
| | - Oded Hershkovich
- Department of Orthopedic Surgery, Edith Wolfson Medical Center, Affiliated to the Sackler School of Medicine, Holon 5822012, Israel
- Medical Corps, Israeli Defense Forces, Ramat Gan 91120, Israel
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