Incidence and Trends in Femur Shaft Fractures in Swedish Children Between 1987 and 2005
Incidence and Trends in Femur Shaft Fractures in Swedish Children Between 1987 and 2005
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DOI：
10.1097/bpo.0b013e31821f9027
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发表时间：
2011-07-01
影响因子：
1.7
通讯作者：
Janarv, Per-Mats
中科院分区：
文献类型：
--
作者：
von Heideken, Johan;Svensson, Tobias;Janarv, Per-Mats
背景：儿童股骨干骨折的手术治疗正在发生变化，住院时间比以前短。这项全国性流行病学研究的目的是按年龄、性别、损伤原因、损伤严重程度和季节变化报告瑞典儿童股骨干骨折的发病率，并分析发病率、治疗方式和住院时间随时间的变化。方法：从瑞典国家医院出院登记中选择1987年至2005年瑞典具有股骨干骨折诊断代码的儿童(N=4984)。结果：每10万名儿童的年总发病率为22.9岁，9.5岁。从1987年到2005年，发病率下降了42%，平均每年3%，从19.4%下降到11.8%(P<；0.001)。4岁以下儿童最常见的伤害原因是1米高空坠落；4至12岁儿童中，运动事故是最常见的伤害原因；13至14岁儿童中，交通事故是最常见的伤害原因。股骨干骨折的发生月份具有双峰季节性变化，高峰出现在3月和8月。在研究期间，治疗方式正在发生变化，从使用牵引转向更多地使用外固定架和弹性髓内钉。住院天数从1987年的26天减少到2005年的5天，下降了81%(P<；0.001)，但与新的手术治疗方法的引入无关。结论：目前全国范围内的股骨干骨折研究显示骨折发生率下降，治疗方式发生转变，住院时间缩短。
Background: The surgical treatment of femur shaft fractures in children is changing, and the time spent in hospital is shorter than before. The purpose of this nationwide epidemiology study is to report incidence of pediatric femur shaft fractures in Sweden during 1987 to 2005 by age, sex, cause of injury, severity of injury, and seasonal variation, and to analyze the change in incidence, treatment modalities, and length of hospital stay over time.Methods: Children (N = 4984) with a diagnostic code for femur shaft fracture in Sweden 1987 to 2005 were selected from the Swedish National Hospital Discharge Registry.Results: The overall annual incidence per 100,000 children was 22.9 in boys and 9.5 in girls. The incidence declined by 42%, on average 3% per year, from 19.4 to 11.8 between 1987 and 2005 (P < 0.001). The most common cause of injury in children younger than 4 years of age was fall of < 1 m; in children 4 to 12 years of age, sports accidents were the most frequent cause of injury; and in children 13 to 14 years of age, traffic accidents. The month of occurrence for femur shaft fractures had a bimodal seasonal variation with a peak in March and in August. Treatment modalities were changing during the study period from the use of traction to an increased use of external fixation and elastic intramedullary nailing. The length of hospital stay decreased by 81%, from 26 days in 1987 to 5 days in 2005 (P < 0.001), but had no correlation to the introduction of new surgical treatment methods.Conclusions: The present nationwide study of femur shaft fractures shows a decrease of fracture incidence, a shift in the treatment modalities, and shorter length of hospital stay.Level of Evidence: Level III, retrospective comparative study.