Predictors of therapeutic complications in bone fractures of children: prospective study of 700 subjects

Background: The objective of the study was to estimate prevalence of therap eutic complications in a department of orthopedics pediatric surgery, and t o determine predictors of minor and serious complications. Methods: Between November 1996 and 1997, children less than or equal to 17 years of age, admitted for bone fracture (head and face excepted) were sele cted in a prospective study. In all, 700 children were treated until bone c onsolidation. Individual, socio-economic, anatomical, environmental and the rapeutic factors were progressively registered All complications were noted . Results: The mean age of the children was 9.2 years; 25 patients could not be traced Prevalence rate of therapeutic complications was 10.3%. In multiv ariate analysis using logistic regression, six factors increased the risk o f adverse event: kind of fracture (diaphysial), comminuted aspect compounde d fracture and Bone displacement, season (spring and autumn), and use of me dical transport between accident place and hospital. The same factors, seas on and compounded fracture excepted, were predictors of serious complicatio ns, Conclusion: The results show that therapeutic complications depend on anato mical and environmental factors above all and that medical procedure is,lot a prognosis factor. So if prevention of fractures is possible before injur y, a better knowledge of initial risk can improve prevention of complicatio ns.