A 10-year study of the changes in the pattern and treatment of 6,493 fractures

A total of 6,493 fractures was studied from 6,389 children younger than 16 years admitted as inpatients to one center in a 10-year period. The boy-to- girl ratio increased from 1.4:1 in the infants to 4.9:1 in the adolescents. The most common fractures were the distal radius (20.2%), supracondylar fr acture of the humerus (17.9%), forearm shaft (14.9%), and the tibial shaft (11.9%). A distinct age-specific fracture pattern also was found, with supr acondylar fracture of the humerus being the most common fracture in the age 0- to 3-year (26.7%) and the 4- to 7-year (31.6%) groups and distal radius in the 8- to Ii-year and the 12- to 16-year groups (24.3 and 25.7%, respec tively). Although the overall pattern of the major fractures had not change d over the 10-year period, significant changes in the treatment pattern wer e observed. The closed-reduction and percutaneous pinning rates increased f rom 9.5 to 38.7% in fracture of the distal radius, 4.3 to 40% in the suprac ondylar humerus, and 1.8 to 22% in the forearm shaft. The changes in treatm ent pattern were also accompanied by a corresponding decrease in the open-r eduction rate and hospital stay periods from <10% to 38% of patients being discharged within 1 day of admission in the 10-year period.