Epidemiology of fractures in children and adolescents different types of broken bones

Umeå, Sweden, situated on the Gulf of Bothnia (64° N), has substantial seasonal variations in weather conditions. Pain medication for broken bones Snow and ice are common between November and April. Images of broken bones The area is mainly urban and offers possibilities for a variety of sports and leisure activities. How long do broken bones take to heal All children who sustain fractures in the municipality of Umeå and surrounding municipalities are seen at UUH, which serves as the regional hospital.


How do bones heal after they are broken During the period 1993–2007, when the data used here were collected, the average annual population aged 0–19 in the region was 34,239.

Injuries seen at the emergency department of the hospital were recorded in a database in accordance with EHLASS (the European Home and Leisure Accident Surveillance System). Broken bones in toddlers Data included variables such as age and sex, date, type and mechanism of injury, activity at injury, and treatment. Pain medicine for broken bones Information was gathered through a questionnaire handed to patients or relatives upon arrival. Repairing broken bones Further information was gathered from reports by ambulance personnel, from the physician’s notes on the case history, and from other possible sources—such as police reports. Effects of broken bones Non-residents were excluded. Common broken bones Residents injured elsewhere were registered if they were identified at follow-up visits. Bad broken bones The database was cross-checked with the hospital’s registry of inpatients, to avoid loss of injuries leading to admittance in the dataset. Broken bones pictures Starting from 1998, the registry of the emergency department’s reception desk was also cross-checked to estimate the number of cases lost due to lack of registration among discharged patients.

From the database, we extracted 10,203 injury events in individuals aged 0–19 years that resulted in 10,327 fractures. Do all broken bones swell Almost all fractures were confirmed radiographically; fractures of the nose and ribs were sometimes diagnosed by clinical examination only. What helps broken bones heal faster We categorized the degree of trauma associated with each fracture event as slight, moderate, or severe in accordance with Landin’s “severity of trauma” definitions (1983).

To validate fracture site recording, we reviewed the radiographs of 10% randomly selected cases from the years 2002–2007. Bad horse falls broken bones These years were chosen because the films were digitized. First aid for broken bones For long bone fractures we used a definition of proximal, diaphyseal, and distal in accordance with AO principles, where the proximal and distal segments are defined by the broadest part of the physis ( Slongo and Audigé 2007). Setting broken bones Only 81% of the sample had been categorized correctly with respect to fracture site, and this led us to review all radiographs for the years 2006 and 2007 (1,520 cases). Do broken bones heal completely Thus, fracture site distribution is presented for these 2 years only.

When analyzing activity at injury, we divided the population into age groups with respect to enrollment in daycare and school and “milestones” in development.

The lack of registration of injuries resulting in discharge for 1998–2007 was estimated to be 7%. Broken bones in kids There were variations over time in the percentage of cases lost due to lack of registration but the percentage was similar at the beginning and the end of the period.

Boys accounted for 61% of all fracture events. Broken bones in the hand The overall male-to-female incidence ratio was 1.5 (CI: 1.5–1.6). What are broken bones The highest incidence ratio between sexes occurred in the 15-year-olds: 3.1 (CI: 2.6–3.6). Who has broken the most bones The peak incidence of fractures occurred at 11–12 years of age in girls and at 13–14 years of age in boys ( Figure 2). Broken ankle bones pictures There were seasonal variations with peaks in March, May-June, and August-September. How to cure broken bones The least number of fractures occurred in December.

We found a 59% increase in incidence over time, which is remarkable and requires scrutiny. Complications of broken bones The database was cross-checked with the hospital’s inpatient registry, so the percentage of fractures resulting in hospitalization that were lost to registration should have been small and near constant over time. What heals broken bones The lack of registration for all fractures, not only those admitted, was evaluated between 1998 and 2007. Who puts casts on broken bones Thus, comparisons over time are more reliable between these years. Support for broken bones Between 1998 and 2007, the incidence of all fractures increased from 213 to 240, with an incidence ratio of 1.1 (CI: 1.0–1.3). What repairs broken bones The incidence of fractures requiring admission increased by 38% during the same period (from 37 to 51), with an incidence ratio of 1.4 (CI: 1.1–1.8). Kids broken bones The greater increase in fractures requiring admission could indicate more serious injuries. Healing broken bones in hand It could also be that the indications for admission were more liberal in the later part of the period. Best painkillers for broken bones However, the average length of stay in hospital was similar over time. How long before broken bones start to heal Also, the percentage of fractures caused by slight trauma but leading to admission decreased while the percentage of fractures caused by moderate and severe trauma increased. How broken bones heal We therefore believe that there was a real increase in fracture incidence between 1998 and 2007.

Why did this increase occur? A recent study by Raustorp and Ludvigsson (2007) showed an increase in daily physical activity in Swedish school children between 2000 and 2006. Broken bones in the foot Also, they found that physical activity levels were not related to BMI. Pain relief for broken bones They concluded that the change in activity levels was due to an increased awareness of the importance of physical activity in daily life, and implementation of programs to enhance such activities. How long does it take for fractured bones to heal The Swedish Sports Council reported a 5% increase in participation in organized sports among teenagers when comparing the years 1998 and 2005, and that children become involved in organized sporting activities at a younger age ( Swedish Sports Council 2005). Type of broken bones Perhaps Swedish children are more active today than in the 1990’s when Tiderius and colleagues (1999) reasoned that the decrease in fracture incidence seen in Malmö between the 1970’s and the 1990’s could be partly explained by a reduced level of spontaneous activity. Broken bones in the foot metatarsals They referred to Engström (1996) who had reported a reduction in spontaneous playing activities in Swedish children.

Petersen and colleagues (2003) showed an increased prevalence of overweight (age-specific BMI corresponding to BMI > 25 at age 18) among children in Umeå between 1986 and 2001. Broken bones heal stronger Overweight children are reported to be at increased risk of sustaning fractures ( Goulding et al. How to check for broken bones 1998, Taylor et al. Pictures of broken wrist bones 2006). Pictures of broken ankle bones Hypothetical explanations for this are greater mechanical loads when falling, low bone strength relative to body mass ( Wetzsten et al. Easily broken bones 2008) and poor balance (Goulding et al. Multiple myeloma broken bones 2002). What is a cast for broken bones Could it be that the increased incidence of fractures is partly explained by increased activity levels among some children and increased prevalence of overweight among others?

When comparing incidence with that in previous studies, one must bear in mind that the most recent studies have looked at individuals from 0 to 16 years of age ( Table 1). Broken bones sticking out It can be argued that children are in most cases skeletally mature by the age of 16. Baby broken bones However, the incidence of fractures in the late teenage years is still high, and is not reached again until the 50s in women and the late 70s in men ( Bergström et al. Doctor games broken bones 2008). Surgery for broken bones For comparative reasons, we calculated the overall incidence for the population aged 0–16 years and the accumulated risk until 16 years of age.

In comparing our results with those of Landin (1983) and Tiderius et al. How to join broken bones (1999), some differences were to be expected given the differences in climate and demographics. Kids health broken bones However, the incidence figures were remarkably similar. Broken bones and fractures Lyons et al. Best pain medication for broken bones (2000) reported differences in incidence between Scandinavian populations and a Welsh population ( Table 1). How are broken bones treated Cooper et al. Do broken bones heal stronger (2004) reported an incidence ratio of 1.7 between districts in Northern Ireland and districts in south-eastern England.

The general predominance of boys is in line with previous results. Easily broken bones in children The reason for this predominance is probably a combination of biological factors and social, gender-related differences related to activity and risk taking. Broken bones signs and symptoms Identification of these factors was not possible in this study, but it could be of value in the future, e.g. Medication for broken bones to help identify fracture-prone individuals in both sexes, and to aid in targeting of preventive measures.

The difference in timing of the peak incidence for boys and girls reflects differences in growth between the sexes. How long does it take to heal broken bones The peak incidence coincides with the pubertal growth spurt, when there is a relative decrease in bone mineral density due to bone expansion and insufficient mineralization ( Faulkner et al. Why do broken bones hurt 2006). Broken bone sticking out of skin The age for the pubertal peak height velocity in the Swedish population is 14 years in boys and 12 years in girls ( Albertsson Wikland et al. Painkillers for broken bones 2002).

Seasonal variations for all fractures have been described by other authors ( Landin 1983, Tiderius et al. How to heal broken bones in foot 1999, Lyons et al. How do broken bones heal video 2000). Pictures of broken bones in hand A unique feature of the present data is the high incidence of fractures in March. Different types of broken bones This is due to “sports vacations”, a week at the beginning of March when children are traditionally encouraged to take part in winter sports. Pictures of broken bones We found that December is the month with the lowest number of fractures and also one of the months with the lowest percentage of outdoor fractures (47%), which can be explained by the lack of daylight in December. What causes broken bones The percentage of outdoor fractures in June, on the other hand, when the days are long and outdoor activities are more frequent was 81%.

During the first years of life, children undergo dramatic developments in motor skills. How to deal with broken bones In their explorations, they tend to fall off furniture and staircases in the first year of life, whereas pre-adolescence children fall off playground equipment, bikes, and other structures. Easily broken bones disease This is reflected in the distribution of injury mechanisms.

The percentage of fractures caused by severe or slight trauma was similar to the corresponding results of Landin (1983) and Tiderius et al. Types of broken bones (1999). Broken bones in children We categorized a greater proportion of events as being caused by moderate trauma (falls from 0.5–3 m, e.g. Broken bones out of skin basketball falls from bicycles, horses, bunk-beds, or swings). How to treat broken bones This was perhaps because we could categorize fewer events as “unknown”.

Children start to participate in organized sports between the ages of 5 and 7. How to treat broken bones first aid This was reflected in the distribution of sports-related fractures, which increased after the age of 5. Broken collar bones Sports accounted for more fractures in our material than in the studies by Landin (1997), Tiderius et al. Bad broken bones in sports (1999), and Rennie et al. Do broken bones heal (2007) but there was a similar percentage of fractures to that reported by Lyons et al. Broken bones in football (1999) in a Welsh population. Broken bones sports injuries This Welsh population showed a higher fracture incidence than Scandinavian populations for the same year, and the authors discussed whether this could be explained by a higher participation in sports. How broken bones heal video They concluded that it could not be taken as the sole explanation. Multiple broken bones Not even a twofold increase in sports and leisure activities could explain the higher incidence. No broken bones Our findings of a higher percentage of sports-related fractures compared to those of Landin and Tiderius et al. Remedies for broken bones are most likely a reflection of differences in registration of data, but they are perhaps also partly due to an increase in participation in organized sporting activities. How to heal broken bones faster Comparisons of activity at injury with previous studies are difficult because of differences in the manner of categorization.

Figures from the Swedish Sports Council show that the most common sports practiced in organized forms by girls are soccer, equestrian sports, and floorball. Broken bones in your hand For boys, they are soccer, floorball, and ice hockey ( Swedish Sports Council 2005). X ray broken bones pictures As expected, soccer accounted for the greatest number of fractures in both sexes. Healing broken bones in the elderly Soccer-related injuries increased over a 10-year period, in both boys and girls, most likely due to an increased participation in organized soccer.

The differences between sexes in the distribution of fractures related to equestrian sports and ice hockey were in accordance with the sex-related distribution of participants. Top 10 broken bones We were unable to identify any organized sport that was associated with a disproportionally high number of fracture events.

This study shows that fractures are common in children in Umeå, with one-third of all children sustaining at least one fracture before the age of 17 years. Ice for broken bones There was an increase in incidence among children and adolescents between 1998 and 2007. All my broken bones We were unable to identify a single activity or mechanism of injury responsible for this increase, and unfortunately this makes it difficult to suggest implementation of any specific preventive measures. Broken leg bones pictures Mechanisms and activities at injury vary with age; this reflects the development of social and motor skills and the changing activities of children as they grow older. Different types of casts for broken bones The fracture pattern is also affected by changes in the mechanical properties of bone during growth, length of day, climate, trends in leisure activities, and even local holidays.

EMH validated and analyzed the data and performed the revision of fracture localization. Broken bones in sports EMH, OS, PM, and UB all discussed the analysis and participated in writing the manuscript. Broken bones heal faster All authors approved the final version.

We thank the staff of the emergency department and injury surveillance group at UUH for their work in compiling and maintaining the database, and Magnus Hellström in particular for his help in extracting and organizing the data. Treating broken bones Thanks also to Hans Stenlund for his advice concerning the statistical analysis.