Pattern of long bone fractures in a paediatric population at Kenyatta National Hospital

Abstract

Background: Paediatric injuries, both accidental and non-accidental are a global public health problem. In developed countries, injuries account for majority of the mortality in paediatric age group after one year of age. Musculoskeletal trauma is the most common form of injury in childhood. Locally, there is a paucity of data on the distribution, cause and severity of childhood fractures.

Objective: This study aimed to determine the pattern of long bone fractures, common mechanisms of injury, severity and location at time of injury in the paediatric age group.

Design: This was a cross-sectional study

Setting: The study was conducted at the Accident and Emergency department, Paediatric Orthopaedic ward and Fracture Clinics in Kenyatta National Hospital.

Methodology: The study had 104 participants. All paediatric patients presenting with long bone fractures between October 2016 and December 2016 were registered, listed and assigned consecutive numbers. Sampling was done for those who met the inclusion criteria and they were recruited into the study. Data obtained was stratified and analyzed based on age of patient, anatomic site of fracture, fracture classification based on the AO PCCF classification system, mechanism of injury and location at the time of injury. Chi- square test was used to analyze categorical variables. The data was summarized in terms of means, medians and modes and categorical data was presented in form of tables, charts and graphs.

Results: One hundred and four participants who had sustained 119 fractures were recruited. Males were 61(59%) and females 43(41%) in number with a median age of 6 years and 5 months (2 – 14 years). Majority had single (84%) and closed (96%) fractures. Majority of the fractures were due to falls (56%) and commonly occurred at home or its surroundings (56%). Upper limb fractures predominated at 53% with majority involving the distal metaphysis of the humerus (70%).

Conclusion: Majority of the long bone fractures in children in our setting occur due to falls in the home or its surroundings and the distal metaphysis of the humerus is the most commonly fractured region. The fractures showed a bimodal type of distribution with peaks at 4 - 6 years and at 12 – 14 years of age. Fractures secondary to RTAs were higher than in other studies.

Keywords: Children, Falls, Long bone fractures, Pattern, Mechanism of injury, Developing countries