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A 10-Year Study of the Changes in the Pattern and Treatment of 6,493 Fractures

Cheng, Jack C. Y. F.R.C.S.E.D.(Orth.); Ng, B. K. W. F.R.C.S.*; Ying, S. Y. M.B.B.S.†; Lam, P. K. W. M.Phil‡

Journal of Pediatric Orthopaedics: May/June 1999 - Volume 19 - Issue 3 - pp 344-350

A total of 6,493 fractures was studied from 6,389 children younger than 16 years admitted as inpatients to one center in a 10-year period. The boy-to-girl ratio increased from 1.4:1 in the infants to 4.9:1 in the adolescents. The most common fractures were the distal radius (20.2%), supracondylar fracture of the humerus (17.9%), forearm shaft (14.9%), and the tibial shaft (11.9%). A distinct age-specific fracture pattern also was found, with supracondylar fracture of the humerus being the most common fracture in the age 0- to 3-year (26.7%) and the 4- to 7-year (31.6%) groups and distal radius in the 8- to 11-year and the 12- to 16-year groups (24.3 and 25.7%, respectively). Although the overall pattern of the major fractures had not changed over the 10-year period, significant changes in the treatment pattern were observed. The closed-reduction and percutaneous pinning rates increased from 9.5 to 38.7% in fracture of the distal radius, 4.3 to 40% in the supracondylar humerus, and 1.8 to 22% in the forearm shaft. The changes in treatment pattern were also accompanied by a corresponding decrease in the open-reduction rate and hospital stay periods from <10% to 38% of patients being discharged within 1 day of admission in the 10-year period.

Study conducted at the Prince of Wales Hospital, Hong Kong

Departments of Orthopaedics and Traumatology, The Chinese University of Hong Kong, and *Prince of Wales Hospital; †Department of Surgery, Prince of Wales Hospital; and ‡Centre for Clinical Trials and Epidemiological Research, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong

Address correspondence and reprint requests to Dr. J. C. Y. Cheng, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, 5/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, N.T., Hong Kong

© 1999 Lippincott Williams & Wilkins, Inc.