Epidemiology of upper extremity musculoskeletal injuries in children

Authors

DOI:

https://doi.org/10.15574/PS.2025.1(86).5964

Keywords:

epidemiology, fractures, upper extremity, adolescent, children

Abstract

This study aimed to determine the epidemiology of upper extremity musculoskeletal injuries that require hospitalization in children and adolescents as a starting point for forming preventive recommendations and introduce measures to reduce morbidity and mortality.

Materials and methods. This was a retrospective analysis of epidemiological data collected from 602 children treated at the Paediatric Surgery Department from 2019-2023 with upper extremity fractures or dislocations. Age, sex, incident circumstances, fracture type, and associated damage were evaluated.

Results. Upper limb musculoskeletal injuries accounted for 16% of all hospital admissions due to injuries to different body parts. The median age of the participants was 9.6 years, ranging from 2 months to 17 years. The main causes of injuries were one-story falls (27%), second-story falls (21%), and traffic accidents (9%). The most common fractures involved the distal epiphysis of the radius and ulna (38.5%), the shafts of the bones of the forearm (26%), and the distal epiphysis of the humerus (15.6%). In the analyzed material, 38% of the children experienced fractures/dislocations at home and 31% experienced fractures/dislocations at school. 21% of fractures were sustained during sports activities.

Conclusion. Upper limb fractures and dislocations are the leading causes of hospitalization in children and adolescents in the surgical department. Upper extremity fractures and dislocations predominantly occur at home, at school, and in their surroundings, especially during sports activities. A one-story fall is the most common cause of these injuries. In traffic accidents, pedestrians usually suffer more complex injuries.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for the study.

The authors declare no conflict of interest.

Author Biography

Slawomir Kiepura, Zeromski Memorial Specialistic Hospital in Krakow

Andrzej Frycz Modrzewski University in Krakow, Poland

References

Barr LV. (2014, Mar). Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. J Child Orthop. 8(2): 167-170. https://doi.org/10.1007/s11832-014-0577-0; PMid:24643672 PMCid:PMC3965762

Cassidy BP, Yeramosu T, Mbomuwa FJ, Chidothi P, Wu HH, Martin C Jr et al. (2024, Jul 16). Epidemiology and Management of Pediatric Fractures in Malawi. J Am Acad Orthop Surg Glob Res Rev. 8(7). https://doi.org/10.5435/JAAOSGlobal-D-24-00026; PMid:39042502 PMCid:PMC11254115

Clark EM. (2014, Sep). The epidemiology of fractures in otherwise healthy children. Curr Osteoporos Rep. 12(3): 272-278. https://doi.org/10.1007/s11914-014-0227-y; PMid:24973964

De Putter CE, van Beeck EF, Burdorf A et al. (2015, Aug). Increase in upper extremity fractures in young male soccer players in the Netherlands, 1998-2009. Scand J Med Sci Sports. 25(4): 462-466. https://doi.org/10.1111/sms.12287; PMid:24990273

Farrell C, Hannon M, Monuteaux MC, Mannix R, Lee LK. (2022, Jul 1). Pediatric Fracture Epidemiology and US Emergency Department Resource Utilization. Pediatr Emerg Care. 38(7): e1342-e1347. https://doi.org/10.1097/PEC.0000000000002752; PMid:35686967

Hedström EM, Bergström U, Michno P. (2012, Sep). Injuries in children and adolescents - analysis of 41,330 injury related visits to an emergency department in northern Sweden. Injury. 43(9): 1403-1408. https://doi.org/10.1016/j.injury.2011.01.027; PMid:21411086

Issin A, Kockara N, Oner A, Sahin V. (2015, Oct). Epidemiologic Properties of Pediatric Fractures in a Metropolitan Area of Turkey. Medicine (Baltimore). 94(43). https://doi.org/10.1097/MD.0000000000001877; PMid:26512602 PMCid:PMC4985416

Jespersen E, Rexen CT, Franz C, Møller NC, Froberg K, Wedderkopp N. (2015, Apr). Musculoskeletal extremity injuries in a cohort of schoolchildren aged 6-12: a 2.5-year prospective study. Scand J Med Sci Sports. 25(2): 251-258. https://doi.org/10.1111/sms.12177; PMid:24472003

MacKay M, Vincenten J. (2014).Tools to Address Childhood Trauma, Injury and Children's Safety: Final Report of the TACTICS Project. Birmingham: European Child Safety Alliance.

Mansoor K, Shahnawaz S, Ahmad A, Arif MM, Hamza M. (2015, Jul-Sep). Epidemiology of childhood fractures in city of Karachi. J Ayub Med Coll Abbottabad. 27(3): 608-612.

Mathison DJ, Agrawal D. (2010, Aug). An update on the epidemiology of pediatric fractures. Pediatr Emerg Care. 26(8): 594-603. https://doi.org/10.1097/PEC.0b013e3181eb838d; PMid:20693861

Merckaert S, Chaibi E, Meriem S, Kwiatkowski B, Divjak N, Zambelli PY. (2021, Dec 1). Epidemiology of Pediatric Upper Extremity Fractures in a Tertiary Care Center in Switzerland. Pediatr Emerg Care. 37(12): e825-e835. https://doi.org/10.1097/PEC.0000000000002047; PMid:32106152

Mohamed AS, Ngom G, Sow M et al. (2016, Feb 8). Scooter accidents in children at Aristide Le Dantec, University Hospital of Dakar: a study of 74 cases. Pan Afr Med J. 23: 32. https://doi.org/10.11604/pamj.2016.23.32.8708

Naranje SM, Erali RA, Warner WC Jr, Sawyer JR, Kelly DM. (2016, Jun). Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. J Pediatr Orthop. 36(4): e45-e48. https://doi.org/10.1097/BPO.0000000000000595; PMid:26177059

Pan RH, Chang NT, Chu D, Hsu KF, Hsu YN, Hsu JC et al. (2014, Feb 5). Epidemiology of orthopedic fractures and other injuries among inpatients admitted due to traffic accidents: a 10-year nationwide survey in Taiwan. ScientificWorldJournal. 2014: 637872. https://doi.org/10.1155/2014/637872; PMid:24672344 PMCid:PMC3932229

Qiu X, Deng H, Su Q, Zeng S, Han S, Li S et al. (2022, Mar 29). Epidemiology and management of 10,486 pediatric fractures in Shenzhen: experience and lessons to be learnt. BMC Pediatr. 22(1): 161. https://doi.org/10.1186/s12887-022-03199-0; PMid:35351043 PMCid:PMC8962138

Russell K, Selci E. (2018). Pediatric and adolescent injury in snowboarding. Res Sports Med. 26; supple 1: 166-185. https://doi.org/10.1080/15438627.2018.1438277; PMid:30431362

Zacay G, Dubnov-Raz G, Modan-Moses D, Tripto-Shkolnik L, Levy-Shraga Y. (2022, Jan). Epidemiology of childhood fractures in Israel during 2000-2019. Bone. 154: 116174. https://doi.org/10.1016/j.bone.2021.116174; PMid:34508878

Published

2025-03-28

Issue

Section

Original articles. Orthopedics