Fractures of Long Bones in Children and Adolescents

Abstract

Competent treatment of fractures in adolescents includes specific knowledge about the incidence, age distribution and causes of these fractures. The current study reports about a multi-centre epidemiological investigation on 682 long bone fractures in children and adolescents involving 13 hospitals in Germany, Austria and Switzerland. The fractures were classified according to the “Li-La” classification, introduced von Laer and co-workers [19]. This classification uniquely takes into consideration the special conditions of fractures in the growth period. There were 1.3 times more fractures in boys than in girls. Most fractures occurred at the age of thirteen to fourteen. Almost 90 % of the fractures were mono-injuries. Somatic pre-disposition factors (cerebral palsy or cystic bone tumours, e. g.) were found in 3.8 %. Most fractures were observed in the upper extremity (73.7 %) and in the metaphysis (65.1 %). The most injured regions were the distal forearm (41.6 %), the distal humerus (14.6 %) and the tibial shaft (10.8 %). Fractures of the shaft decreased after the age of ten, whereas articular fractures significantly increased at the end of adolescence. The most frequent cause was sports activity followed by accidents at home or on playgrounds. There was significant relation between distal humerus fractures in infants and playground accidents, distal forearm fractures and sports injuries, and tibia-fibula and ankle fractures after traffic accidents in teenagers.

fracture - adolescence - childhood - incidence - risk factors

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