scholarly journals Epidemiology of skeletal trauma and skull fractures in children younger than 1 year in Shenzhen: a retrospective study of 664 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hansheng Deng ◽  
Xin Qiu ◽  
Qiru Su ◽  
Shuaidan Zeng ◽  
Shuai Han ◽  
...  
Keyword(s):  
Pediatric Trauma ◽  
Unintentional Injury ◽  
Length Of Hospital Stay ◽  
Epidemiological Studies ◽  
Fracture Site ◽  
Demographic Characteristics ◽  
Skull Fractures ◽  
Skeletal Trauma ◽  
Delayed Treatment ◽  
Fractures In Children

Abstract Background Unintentional injury is one of the top three causes of death for infants. However, the epidemiological studies of skeletal trauma and skull fractures in infants younger than 1 year were poorly understood in China. Therefore, our study aimed to examine accidental and emergency attendance in infants under 1 year. It also tried to determine the prevalence and severity of accident types in infants. Methods A retrospective analysis was performed on the demographic characteristics of infants younger than 1 year with skeletal trauma and skull fractures who visited the Shenzhen Children’s Hospital from January 1, 2016 to December 31, 2019. Age, gender, fracture site and type, mechanism of injury, length of visit, length of hospital stay, hospitalization cost, and treatment methods were analyzed. Results A total number of 675 fractures in 664 infants were included, the median age was 187days (IQR,90-273days), including 394 males and 270 females. The top three fracture sites were the skull (430 sites, 63.70 %), long bones of the limbs (168 sites, 24.89 %), and clavicle (53 sites, 7.85 %). The top three causes of injury were locomotion injuries (256 cases, 38.55 %), falls or trips from low height (from beds, tables, chairs, etc.) (130 cases, 19.58 %), and birth injuries (97 cases, 14.61 %). The greatest amount of fractures occurred in children 1–28 days of life (d) reached a top of 101 cases, followed by 331–365 days, accounting for 15.21 and 10.24 %, respectively. The number of fractures reached a trough of 29 cases in the 29-60d group (4.37 %). And increased again to 65 cases in the 151-180d group (9.79 %). The proportion remained relatively constant at 9 % in the 181-210d group (9.19 %) and 211-240d group (9.64 %). The interval between injury and visiting our hospital was ≤ 72 h in 554 cases. Conclusions Special attention should be given to the demographic characteristics of fractures in infants under 1 year of age, and appropriate outreach should be implemented. For example, health education should be provided to aid in the prevention especially for frequently occurring locomotion injuries, and prompt access to specialist medical care should be recommended for skull fractures, which are prone to delayed treatment. In addition, multidisciplinary collaboration should be implemented in trauma care, while also promoting the establishment of trauma centers in specialist children’s hospitals with a stronger capacity to treat pediatric trauma, and a regional system for pediatric trauma treatment.

scholarly journals Epidemiology of Skeletal Trauma and Skull Fractures in Children Younger Than 1 Year in Shenzhen: A Retrospective Study of 664 Patients

2021 ◽  
Author(s):  
Hansheng Deng ◽  
Xin Qiu ◽  
Qiru Su ◽  
Shuaidan Zeng ◽  
Shuai Han ◽  
...  
Keyword(s):  
Pediatric Trauma ◽  
Unintentional Injury ◽  
Length Of Hospital Stay ◽  
Epidemiological Studies ◽  
Fracture Site ◽  
Skull Fractures ◽  
Skeletal Trauma ◽  
Delayed Treatment ◽  
Fractures In Children ◽  
Epidemiological Characteristics

Abstract Background: Unintentional injury is one of the top three causes of death for infants. However, the epidemiological studies of skeletal trauma and skull fractures in infants younger than 1 year were poorly understood in China. Therefore, our study aimed to examine accidental and emergency attendance in infants under 1 year. It also tried to determine the prevalence and severity of accident types in infants and to propose ways to reduce such accidents.Methods: A retrospective analysis was performed on the epidemiological characteristics of infants younger than 1 year with skeletal trauma and skull fractures who visited the Shenzhen Children's Hospital from 2016 to 2019. Their age, gender, fracture site and type, mechanism of injury, length of visit, length of hospital stay, hospitalization cost, and treatment methods were analyzed.Results: A total of 664 infants were included, the median age was 187days (IQR,90-273days), including 394 males and 270 females. The top three fracture sites were the skull (430 sites, 63.70%), long bones of the limbs (168 sites, 24.89%), and clavicle (53 sites, 7.85%). The top three causes of injury were locomotion injuries (256 cases, 38.55%), falls or trips (from beds, tables, chairs, etc.) (130 cases, 19.58%), and birth injuries (97 cases, 14.61%). The number of fracture cases was 101 in the 1-28d group (15.21%), which reached a trough of 29 cases in the 29-60d group (4.37%), and a peak of 190 cases (28.61%) in the 151-240d group. The interval between injury and visiting our hospital was ≤72h in 554 cases.Conclusion: Special attention should be given to the epidemiological characteristics of fractures in infants under 1 year of age, and appropriate outreach should be implemented. For example, health education should be provided especially for frequently occurring locomotion injuries, and prompt access to specialist medical care should be recommended for skull fractures, which are prone to delayed treatment. In addition, multidisciplinary collaboration should be implemented in trauma care, while also promoting the establishment of trauma centers in specialist children’s hospitals with a stronger capacity to treat pediatric trauma, and a regional system for pediatric trauma treatment.

Neurogenic claudication associated with posterior vertebral rim fractures in children

2012 ◽  
Vol 10 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Jerome Boatey ◽  
Alison Brayton ◽  
Andrew Jea
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Pediatric Age Group ◽  
Fractures In Children ◽  
The Mean

Object Outside of the patient population with achondroplasia, neurogenic claudication is rare in the pediatric age group. Neurogenic claudication associated with posterior vertebral rim fracture is even more uncommon but nonetheless causes pain and disability in affected children and adolescents. The purpose of this study was to describe the surgical results of 3 adolescents presenting with neurogenic claudication and posterior vertebral rim fracture when treated with laminectomy alone. Methods The medical and operative records of the 3 pediatric patients were retrospectively reviewed. Presenting signs and symptoms and CT findings, such as the interpedicular distances between T-12 and L-5, were obtained. Perioperative results were assessed, including operative time, blood loss, length of hospital stay, and complications. Findings at latest follow-up were also recorded, including a patient satisfaction survey. Results The 3 patients (1 girl and 2 boys) had a mean age of 14.7 years (range 14–15 years) and underwent follow-up for a mean of 11.3 months (range 5–18 months). Notable preoperative signs and symptoms included back pain (all patients), leg pain (all patients), leg numbness (1 patient), and leg weakness (1 patient). No patient presented with bowel and/or bladder dysfunction. The mean blood loss during laminectomy was 123 ml (range 20–300 ml), and the mean length of hospital stay was 4.3 days (range 3–6 days). On average, decompression was performed at 2.2 levels (range 2–2.5 levels). All 3 patients reported at most recent follow-up that they were “satisfied” with the surgery. There was 1 complication of instability from an iatrogenic pars fracture, which required reoperation and posterior instrumented fusion. Conclusions To the best of the authors' knowledge, this report represents the first surgical series of pediatric neurogenic claudication associated with posterior vertebral rim fractures. Pediatric neurosurgeons may infrequently encounter neurogenic claudication associated with a posterior vertebral rim fracture in children. To treat children with neurogenic claudication associated with posterior vertebral rim fractures, a simple laminectomy may be a safe and efficacious alternative to discectomy and removal of fracture fragments.

scholarly journals Does the location of short-arm cast univalve effect pressure of the three-point mould?

2020 ◽  
Vol 14 (3) ◽  
pp. 236-240
Author(s):  
Blake K. Montgomery ◽  
Kenneth H. Perrone ◽  
Su Yang ◽  
Nicole A. Segovia ◽  
Lawrence Rinsky ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Fracture Site ◽  
Radius Fractures ◽  
Sensory Inputs ◽  
Fractures In Children ◽  
Modifiable Factors ◽  
Loss Of Reduction ◽  
Ulnar Aspect ◽  
Volar Surface

Purpose Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however, the risk for re-displacement is high (7% to 39%). Proper cast application and the three-point moulding technique are modifiable factors that improve the ability of a cast to maintain the fracture reduction. Many providers univalve the cast to accommodate swelling. This study describes how the location of the univalve cut impacts the pressure at three-point mould sites for a typical dorsally displaced distal radius fracture. Methods We placed nine force-sensing resistors on an arm model to collect pressure data at the three-point mould sites. Sensory inputs were sampled at 15 Hz. Cast padding and a three-point moulded short arm fibreglass cast was applied. The cast was then univalved on the dorsal, volar, radial or ulnar aspect. Pressure recordings were obtained throughout the procedure. Results A total of 24 casts were analyzed. Casts univalved in the sagittal plane (dorsal or volar surface) retained up to 16% more pressure across the three moulding sites compared with casts univalved in the coronal plane (radial or ulnar border). Conclusion Maintaining pressure at the three-point mould prevents loss of reduction at the fracture site. This study shows that univalving the cast dorsally or volarly results in less pressure loss at moulding sites. This should improve the chances of maintaining fracture reductions when compared with radial or ulnar cuts in the cast. Sagittal plane univalving of forearm casts is recommended.

scholarly journals TITANIUM ELASTIC NAIL - COMPLICATIONS IN THE TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURE OF FEMUR§

2013 ◽  
Vol 7 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Saikat Sarkar ◽  
Ranadeb Bandyopadhyay ◽  
Arindam Mukherjee
Keyword(s):  
Femoral Shaft ◽  
Shaft Fracture ◽  
Fracture Site ◽  
Diaphyseal Fracture ◽  
Entry Site ◽  
Superficial Infection ◽  
Femur Fractures ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Proximal Migration

Background: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Methods: A prospective study was conducted in five private hospitals in the district of Bankura, West Bengal over a period of two years (April 2010 to March 2012) on 70 patients with closed shaft femur fractures between 6- 14 years age of either sex. The aim was to find out the short term complications of titanium elastic nailing in diaphyseal fracture of femur in children and compare the findings of this study with pre- existing studies in this field. Results: In our study the most common complication was pain at nail entry site (60%). 5.71% had local inflammatory reaction due to nails. Superficial infection occurred in 2.85%. At the end of 1 year, 2.85% had limb length discripancies. Proximal migration occurred in 2.85%. 2.85% encountered acute reactive synovitis, 5.71% developed angulation of fracture site and 2.85% developed per operative breakage of nail. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). In our study, we encountered only a few complications most of them being minor. Most of the complications were surgical technique related and were seen at the initial phase of the learning curve.

Nondepressed Linear Skull Fractures in Children Younger Than 2 Years

2012 ◽  
Vol 51 (8) ◽  
pp. 745-749 ◽  
Author(s):  
Samuel R. Reid ◽  
Meixia Liu ◽  
Henry W. Ortega
Keyword(s):  
Skull Fractures ◽  
Fractures In Children

Prevalence of Dystonia in Antioquia, Colombia

2016 ◽  
Vol 46 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Juan Marcos Solano Atehortúa ◽  
Sandra Patricia Isaza Jaramillo ◽  
Ana Rendón Bañol ◽  
Omar Buritica Henao
Keyword(s):  
Epidemiological Studies ◽  
Demographic Characteristics ◽  
Linear Modeling ◽  
Delay In Diagnosis ◽  
True Prevalence ◽  
High Prevalence ◽  
The World ◽  
Different Types ◽  
Capture Recapture ◽  
Log Linear

Background: There are few published epidemiological studies concerning dystonia. Its true prevalence has been difficult to establish. There is no data published in Latin America on this matter. Methods: In this study the prevalence of dystonias in the Department of Antioquia (Colombia) was estimated using a capture-recapture methodology with log-linear modeling, including cases in 3 centers for neurological referrals that cover the Department of Antioquia from 2007 to 2012. Results: The overall prevalence was 712 per 1,000,000 (95% CI 487-937). Of the total of 874 patients, 79% had primary dystonias, and 75.5% had focal dystonias. The delay in diagnosis was longer for primary dystonias, with a median of 1 year. Conclusion: We found a high prevalence of dystonias in Antioquia. The frequency of the different types of dystonias, as well as the demographic characteristics of our patients, is similar to data from other populations of the world.

scholarly journals Delayed treatment of supracondylar elbow fractures in children

2012 ◽  
Vol 98 (7) ◽  
pp. 808-812 ◽  
Author(s):  
J.B. Yaokreh ◽  
T.H. Odehouri-Koudou ◽  
S. Tembely ◽  
A.G. Dieth ◽  
D.B. Kouamé ◽  
...  
Keyword(s):  
Delayed Treatment ◽  
Fractures In Children ◽  
Elbow Fractures
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