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Epidemiology of Fractures in Children Younger Than 12 Months

Rodà, Diana, MD*; Trenchs, Victoria, MD, PhD; Curcoy, Ana Isabel, MD, PhD; Martínez, Anibal Dolores, MD; Pou, Jordi, MD, PhD*; Luaces, Carles, MD, PhD

doi: 10.1097/PEC.0000000000001157
Original Articles
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Objectives The aim of this study is to determine the prevalence and characteristics of fractures in young infants attended at the pediatric emergency department (PED).

Methods This is a retrospective study for 2 years (2011–2012) of children younger than 12 months attended with a fracture at the PED. Age, sex, site and type of fracture, mechanism of injury, time interval before seeking medical attention, and management were analyzed.

Results One hundred one patients were included. They represented 0.3% (95% confidence interval, 0.2%–0.4%) of all children younger than 12 months attended at the PED. The median age was 7.7 months (interquartile range, 5.2–10.1 months); 58 (57.4%) were boys. The most common fracture was skull fracture (58, 57.4%), mostly parietal, followed by long bone fractures (27, 26.7%); transverse and torus fractures were the most common types, located at the diaphysis and distal metaphysis, respectively. The principal mechanism reported was falling (83, 82.2%) mainly from furniture. Fifty-one patients (50.1%) were attended in the first 6 hours after injury. Sixty-five patients (64.4%) were admitted at the hospital and the other 9 (8.9%) were controlled in outpatient visits. One of them was injured because of negligence and another was diagnosed with osteoporosis.

Conclusions Fractures in young infants are uncommon at the PED, the skull fracture being the most common. Pediatricians should alert caretakers of the risks in normal development to prevent these injuries. Fractures caused by child abuse should always be discarded.

Fractures in children are common, but there is little reported about their epidemiology in young infants, and what there is normally related to fractures caused by child abuse.

From the *Pediatric Department,

Pediatric Emergency Department, and

Traumatology Department, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.

Disclosure: The authors declare no conflict of interest.

Reprints: Victoria Trenchs, MD, PhD, Pediatric Emergency Department, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08940, Esplugues de Llobregat, Barcelona, Spain (e-mail: vtrenchs@hsjdbcn.org).

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