Abstract:

Background: Pediatric fractures are increasingly being recognized as a major public health problem worldwide. Little information is currently available on this type of injury in our local environment as there is a paucity of published data on this subject. This study aimed to determine the causes, patterns and treatment modalities of pediatric fractures in our local setting. The study provides baseline data for the establishment of prevention strategies as well as treatment guidelines.

Methods: This was a cross sectional study of pediatric patients presenting with long bone fractures at BMC from January 2019 to July 2019. All subjects that agreed to participate into the study were interviewed by the principal investigator or research assistant. The study was conducted at the EMD, in the neonatal ward and pediatric orthopedic & trauma wards of BMC. Data were entered using epi-Data version 3.1 (Atlanta, US) and analyzed using STATA version 13 (Collage Station, Texas, US). Ethical clearance was sought from the relevant authorities before commencement of the study.

Results: A total of 111 pediatric trauma patients (M: F ratio = 1.2: 1) with fractures were studied. The age peak incidence at presentation was 5-10 years accounting for 48.6% of cases. The majority of the fractures were due to falls (46.8%) and commonly occurred at home (48.6%). Upper limb fractures predominated (57.7%) with the majority involving the distal metaphysis (supracondylar) of the humerus (50.5%). Open fractures were observed in 15 (13.5%) cases and all of them were Gustillo-type II. Only 7 (6.3%) patients received prehospital care. The majority of the patients, 74 (66.7%) were treated surgically mainly with open reduction and internal fixation accounting for 53.2% of cases.

Conclusion: This study demonstrated that the majority of pediatric fractures in our setting occur due to falls around home environment and commonly affect children aged 5-10 years. The most common site of fracture was the humerus with the majority involving the distal metaphysis. Preventive measures targeting at reducing the occurrence of fall injuries in children is necessary to reduce the occurrence of pediatric fractures in this region.