Epidemiology of fractures in children and adolescents

Figures & data

Table 1.  Overview of epidemiological studies describing children's fractures

First author	Age group	Study period	Location	Incidence per 10^4	Most common fracture site	Most common mechanism of injury
Landin	0–16	1950–1979	Sweden	212	Distal forearm 23%	Falls
Cooper	0–17	1988–1998	Great Britain	133	Forearm 30%	N.A.
Kopjar	0–12	1992–1995	Norway	128	Distal radius 27%	Falls 71%
Tiderius	0–16	1993–1994	Sweden	193	Distal forearm 26%	Falls on ground level 40%
Lyons ^a	0–14	1996–1996	Scandinavia	156–178	Forearm 20%	Falls
Lyons ^b	0–14	1996–1996	Wales	361	Forearm 36%	Falls
Brudvik	0–15	1998–1998	Norway	245	Distal forearm 27%	N.A.
Rennie	0–15	2000–2000	Scotland	202	Distal forearm 33%	Falls < 1 m 37%
Our results	0–19	1993–2007	Sweden	201	Distal forearm 26%	Falls < 0.5 m 24%

^a Lyons' results from districts in Sweden, Norway, and Finland.

^b Lyons' results from a Welsh district.

Figure 1.  Age- and sex-adjusted incidence for both boys and girls and age-adjusted sex-specific incidence over time.

Table 2.  Number of fractures, population at risk, and age- and sex-adjusted incidence for each year

Year	Fractures	Population at risk	Incidence /10^4 person years
1993	499	34,661	151
1994	497	34,961	149
1995	612	35,206	179
1996	604	35,275	176
1997	657	35,097	191
1998	728	34,776	213
1999	715	34,490	209
2000	685	34,136	200
2001	733	33,824	211
2002	775	33,686	224
2003	712	33,641	207
2004	790	33,641	229
2005	769	33,534	224
2006	763	33,386	223
2007	788	33,273	240

Figure 2.  Sex-specific fracture incidence and incidence ratios for each year of age.

Table 3.  Distribution of fracture sites, crude incidence, and percentage of all fractures, 2006–2007

Fracture site	Number of fractures	Incidence /10^5 person years	Proportion (%)
Distal forearm	393	591	26
Clavicle	163	245	11
Fingers	149	224	10
Ankle	108	162	7
Toes	83	125	5
Metatarsals	79	119	5
Distal humerus	78	117	5
Metacarpals	78	117	5
Facial skeleton	51	77	3
Tibial/fibular shaft	47	71	3
Proximal forearm	46	69	3
Forearm shaft	46	69	3
Proximal humerus	38	57	3
Carpals	32	48	2
Proximal tibia/fibula	18	27	1
Ribs	17	26	1
Femoral shaft	15	23	1
Thoracolumbar spine	14	21	1
Distal femur	13	20	1
Tarsals	12	18	1
Humeral shaft	10	15	1
Skull	8	12	1
Other sites	22	33	1

Table 4.  Distribution of injury mechanisms

Injury mechanism	Events	Proportion (%)
Fall on the same plane	2,489	24
Collision with/struck by physical object, another person, or animal	2,407	24
Fall between planes	2,319	23
Traffic	1,227	12
Downhill fall	1,099	11
Crushed, cut or stuck	334	3
Other	328	3
Total	10,203	100

Figure 3.  Distribution of injury mechanisms for each year of age.

Figure 4.  Sports-related injuries in each sex, broken down by the type of sport practiced at injury.