AI Article Synopsis
- Proximal humerus fractures in children represent 2% of all pediatric fractures, with an incidence of 31.4 per 100,000, showing no increasing trend over the study period of 2005-2015.
- During this time, 92% were treated nonoperatively; however, the use of surgical fixation grew from 0% to 16%, particularly for fractures with bayonet displacement, which significantly raised the likelihood of surgery.
- Activities like horse riding, skiing, and trampolining were common causes of these injuries, suggesting a link between recreational activities and fracture incidence.
Article Abstract
Background: Proximal humerus fractures comprise approximately 2% of all pediatric fractures. In general, upper extremity fractures have increased in children. However, recent trends of proximal humerus fractures are not analyzed yet. The aim was to study the incidence and treatment trends of proximal humerus fractures in children.
Methods: All 300 children, aged < 16 years, who suffered from a proximal humerus fracture in the catchment area of Oulu University Hospital, Finland, between 2005 and 2015, were included. Radiographs were reviewed, and patients, injuries, treatments, and outcomes were comprehensively studied. Annual incidence was based on the child population at risk, which changed between 84.500 and 88.100 in the study time.
Results: The annual incidence of childhood proximal humerus fractures was mean 31.4/100,000 and no variation trend was found. The majority (92%) was treated nonoperatively, however, there was an increase of operative fixation from 0 to 16% during the study time (Difference 16, 95% CI 0.3 to 34.9%, P = 0.045). Bayonet displacement increased the risk of surgical fixation up to 16-fold (95% CI 4.8-51.4, P < 0.001) in a multivariate analysis when adjusted with other potential risk factors. Higher age was also associated with operative treatment (P = 0.002). The most usual recreational activities were horse riding, downhill skiing, snowboarding, and trampolining.
Conclusion: Contrary to most upper extremity fractures in children, proximal humerus fractures did not increase during the long study period. However, their operative treatment increased compared to nonoperative treatment, but the evidence supporting that trend remains unclear.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882178 | PMC |
| http://dx.doi.org/10.1186/s12891-019-2948-7 | DOI Listing |
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