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April 08, 2013

New Research Looks at the Causes and Most Common Types of Broken Bones in Children

Fractures to the wrist are the most common in children under age 16;
snowboarding causes the most fractures per hour of exposure


Rosemont, Ill. –  While broken bones are not uncommon in children, a new study appearing in the April 2013 Journal of Bone and Joint Surgery (JBJS)looks at which fractures are most common in children, and which activities are most likely to cause fractures.
Approximately one-third of pediatric fractures occur during sport or recreational activity.  In this Norwegian study, researchers sought to determine the incidence and causes of pediatric fractures in children under age 16 by evaluating 1,403 fracture cases over a 12 month period. Exposure time to the most common childhood activities was measured through random interviews with parents in the study population.
There was an overall annual incidence rate of 180.1 fractures per 10,000 children. The distal radius, or wrist, was most often fractured (436 fractures, or 31.1 percent of all injuries), followed by fingers (436 or 31.1 percent) and toes (247 or 17.6 percent). Snowboarding was associated with the highest activity-specific fracture rate (out of 15 activity categories), estimated to be 1.9 fractures per 10,000 hours of exposure, which is four times higher than the fracture rates for soccer, and five times higher than trampoline use.

“In our study we discovered that snowboarding caused four times more fractures per exposure time compared to other common childhood activities,” said orthopaedic surgeon and lead study author Per-Henrik Randsborg, MD, PhD. “Furthermore, trampoline use did not seem to cause more fractures per hours of exposure than other popular childhood activities. In fact, handball and soccer had a higher risk of fractures than did trampoline use.”
Other Key Findings:
  • The mean age of all fractures was 10, and there were more fractures in boys (61.7 percent of all fractures).
  • Winter activities causing the most fractures per weekly hours of exposure were snowboarding, followed by playground use, ice skating and team handball (European).
  • High fracture activities in the summer months per weekly hours of exposure were team handball, followed by skateboarding/rollerblading, soccer, and playground and trampoline use.
  • Soccer has the highest rate of fractures overall, when not accounting for hours of exposure, followed by playground, bicycle and trampoline use.
  • Snowboarding is associated with a highest rate of wrist-specific fractures compared with other activities. Most of the children suffering wrist injuries while snowboarding were not wearing wrist guards.
“Our study indicates what childhood activities give the highest risk of fracture per time exposed to the activity,” said Dr. Randsborg. “The findings will be useful in identifying which activities that should be targeted for further studies regarding the implementation of effective preventive measures, so that children might continue to be physically active while reducing the number of preventable injuries.”

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The American Academy of Orthopaedic Surgeons offers the following sports safety recommendations:  
About JBJS
April Full JBJS Table of Contents
  1. Vetebral Body Stenting versus Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures – a Randomized Trial
  2. Perspectives on ‘Vertebral Body Stenting versus Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures – a Randomized Trial
  3. The Modified Dunn Procedure for Unstable SCFEs: A Multicenter Perspective
  4. It’s not as Easy as It Looks
  5. Surgical Treatment of Chronic Exertional Compartment Syndrome of the Leg: Failure Rates and Postoperative Disability in an Active Patient Population
  6. Perspectives: Surgical Treatment of Chronic Exertional Compartment Syndrome of the Leg: Failure Rates and Postoperative Disability in an Active Patient
  7. The Mechanism of Action of Induced Membranes in Bone Repair
  8. Intensive Care Unit versus Hospital Floor: A Comparative Study of Postoperative Management of Adolescent Idiopathic Scoliosis Patients
  9. Treatment of Advanced Stages of Hallux Rigidus with Cheilectomy and Phalangeal Osteotomy
  10. Axonal Loss in Murine Peripheral Nerves Following Exposure to Recombinat Human Bone Morphogenetic Protein-2 in Absorbable Collagen Sponge
  11. A Novel Patellofemoral Scoring System for Patellofemoral Joint Status
  12. Clinical and Radiographic Outcomes of Failed Repairs of Large or Massive Rotator Cuff Tears: Minimum 10 Year Follow-up
  13. Premenopausal Women with Distal Radius Fractures Have Deteriorated Trabecular Bone Density and Morphology Compared to Non-Fracture Controls
  14. Local Vitamin C Injection Reduced Tendon Adhesion in a Chicken Model of Injured Flexor Digitorum Profundus Tendon Injury
  15. Antimicrobial Peptides and Pro-inflammatory Cytokines in Periprosthetic Joint Infection
  16. Fractures in Children: Epidemiology and Activity-Specific Fracture Rates
  17. Complications Following Tension Band Fixation of the Patellar Fractures with Cannulated Screws versus Kirschner Wires
  18. Hemophilic Arthropathy of Shoulder Joints: Clinical, Radiological, and Ultrasonographic Characteristics of 70 Patients
  19. ACL Injury Prevention Programs
  20. Authorship Proliferation in the Orthopedic Literature
  21. What is the Relationship Between Number of Publications During Orthopaedic Residency and Selection of an Academic Career?
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