DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173764

Epidemiological characteristics of pediatrics fracture at tertiary care hospital, Malaysia

Amit Bhardwaj, Sivapathasundaram N Sivapatha, Mohamad Fauzlie B Yusof Yusof, Nirmal Kumar Sinha Sinha, A. Arieff Atan

Abstract


Background: Childhood fracture resulting from trauma has become a major cause of morbidity, disability and socio-economic burden worldwide as well as Malaysia. So, we aim to assess the various epidemiological parameters that influence the etiology of fracture among the pediatrics population at Melaka, Malaysia and to establish data to develop effective preventive strategies.

Methods: A hospital based cross sectional study was conducted at Melaka General Hospital, Melaka from January 2013 to December 2013. There were total 369 pediatrics fracture cases admitted to MGH during study period.

Results: Among 369 cases, (64.2%) of cases were found among school going age followed by (30.9%) among toddler and (4.9%) of cases among infant. (69.6%) of cases were males and most of them were Malay (87.3%) The incidents occurred mostly in evening around 6pm most significantly in between 10 am to 11 pm. The most common place of injury was at home (40.4%) and fall (77.2%) is the most common mechanism of injury. Left upper extremity involved majority of facture and common site of injuries were around elbow. Epiphyseal injuries account for (9.4 %) and among them distal radius epiphyseal injury account for (68.6 %) which is statically significant (P=0.00).

Conclusions: We concluded that the common mechanism of fracture was fall, (low energy trauma) occurred at home involving left upper extremity around elbow. We believed that community based education by health care professionals and paediatricians on prevention strategies can be instrumental in reducing the incidence of paediatric fractures. 


Keywords


Fracture, Malaysia, Pediatrics trauma

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References


Wegmann H, Orendi I, Singer G, Eberl R. The epidemiology of fractures in infants-Which accidents are preventable? Injury. Int J Care Injured. 2016;47:188-91.

Sebastian van As AB. Paediatric trauma care. Afr J Paediatr Surg. 2010;7(3):129-33.

Peden M. World report on child injury prevention appeals to "Keep Kids Safe". Inj Prev. 2008;14(6):413-4.

Rockwood CA, Wilkins KE, King RE, editors. Fractures in children. Philadelphia: JB Lippincott; 1984.

Iqbal QM. Long bone fractures among children in Malaysia. Int Surg. 1974;59:410-5.

Mann DC, Rajmaira S. Distribution of physeal and nonphyseal fractures in 2,650 long bone fractures in children aged 0-16 years. J Pediatr Orthop. 1990;10:713-6.

Asim A Mohamed NFR, Rukmanikanthan S. Pattern of distal radius fracture in Malaysian children. Med J Malaysia. 2012;67(5):483-6.

Ramaesh, R, Clement N. D, Rennie L. Social deprivation as a risk factor for fractures in childhood. Bone Joint J. 2015;97-B:240-5.

Spady DW, Saunders DL, Schopflocher DP, Svenson LW. Patterns of injury in children: a population-based approach. Pediatrics. 2004;113(3):522-9.

Gediu E. Accidental injuries among children in Northwestern Ethiopia. East Afr med J. 1994; 71:807-10.

Moon RJ, Harvey NC, Curtis EM et al. Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom. Bone. 2016;85:9-14.

Tandon MS, Modi N. Paediatric trauma epidemiology in an urban scenario in India. J Orthopaedic Surg. 2007;15(1):41-5.

Peden M. World report on child injury prevention. Geneva: WHO; 2008.

Ministry of Health Malaysia. Department of Public Health. Annual Report; 2004.

UNICEF Innocenti Working Papers: Child Mortality and Injury in Asia; 2008.

Nathorst WJA. Environmental factors in childhood accidents. A prospective study in Goteborg, Sweden. Acta paediatrScand Suppl. 1982;291:1-75.

Shank LP, Bagg RJ, Wagnon J. Etiology of pediatric fractures: the fatigue factors in children’s fractures. Proceedings of the 4th National Conference on Pediatric Trauma. Indianapolis, Indiana, 1992:24-6.

Karbakhsh M, Zargar M, Zarei MR, Khaji A. Childhood injuries in Tehran: a review of 1281 cases. Turkish J Pediatr. 2008;50(4):317.

Pitone ML, Attia MW. Patterns of injury associated with routine childhood falls. Pediatr Emerg Care. 2006;22:470-4.

Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007;38:913-22.

Valerio G, Galle F, Mancusi C. Pattern of fractures across pediatric age groups: analysis of individual and lifestyle factors. BMC Public Health. 2010;10:656.

Tripathi RB SR, Ali R, Bachhar B and Singh A. Clinico epidemiological study on paediatrics fractures at Narayani sub regional hospital, Birganj. Journal of GMC Nepal. 2009;2(2):39-44.

Borton D, Masterson E, O’Brien T. Distal forearm fractures in children: the role of hand dominance. J Pediatr Orthop, 1994;14:496-7.