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Zhu T, Qiu X, Deng H, Feng H, Chen J, Huang Z, Li J, Liu S, Wang S, Gu Z, Wu Z, Yang Q, Liu G, Sechi LA, Caggiari G, You C, Fu G. Clinical analysis of 1301 children with hand and foot fractures and growth plate injuries. BMC Musculoskelet Disord 2024; 25:270. [PMID: 38589862 PMCID: PMC11000401 DOI: 10.1186/s12891-024-07407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. METHODS We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first-fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first-fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. RESULTS Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. CONCLUSIONS In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries.
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Affiliation(s)
- Tianfeng Zhu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Xin Qiu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Hansheng Deng
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Orthopaedic Department, Sassari University Hospital, 07100, Sassari, Italy
| | - Haoran Feng
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Jianlin Chen
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Zilong Huang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Jiahui Li
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shizhe Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shuaiyin Wang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhenkun Gu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhengyu Wu
- Clinical research center, Hefei cancer hospital, Chinese academy of sciences, Hefei, People's Republic of China
| | - Qisong Yang
- Hefei center for disease control and prevention, Hefei, People's Republic of China
| | - Gen Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | | | | | - Chao You
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
| | - Guibing Fu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
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Sharadze D, Abramov A, Konovalov O, Fomina A, Generalova Y, Kakabadze E, Bokova E, Eliseeva T, Kostinskaya M, Smirnov D, Urazgulov A. THE INCIDENCE OF SPORTS INJURIES AMONG SCHOOL-AGED CHILDREN AND ADOLESCENTS. Georgian Med News 2023:193-198. [PMID: 38096539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
It is estimated that approximately one in ten school-aged children experience sports-related injuries annually. These injuries are most common at 12 years of age. Boys are more likely to get injured and more likely to get seriously injured than girls. The probability of injury is greater in contact or high-impact sports, with American soccer accounting for the largest number of injuries, followed by wrestling, basketball, soccer, and baseball. In certain sports, such as horseback riding, women are four times more likely to sustain injuries. The presented literature review details the incidence of various sports-related injuries in adolescents. Sports-related injuries observed in children under the age of 10 are nonspecific and include contusions, mild sprains, and fractures of the extremities, most commonly Salter-Harris fractures (growth plate fractures) or plastic fractures. In young athletes, sports-related injuries of the ligaments or muscles, as well as spinal or head injuries, are rare. This is particularly true during puberty, where growth plate fractures and musculoskeletal injuries occur more frequently.
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Affiliation(s)
- D Sharadze
- 1State Budgetary Institution "Children's City Polyclinic No. 130" of the Moscow City Health Department, Russia
| | - A Abramov
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - O Konovalov
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - A Fomina
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - Yu Generalova
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - E Kakabadze
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - E Bokova
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - T Eliseeva
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - M Kostinskaya
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - D Smirnov
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
| | - A Urazgulov
- 2Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN), Moscow, Russia
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Onay T, Çelen ZE, Bayhan M, Kandemir İ, Kiliç NC, Kayaalp ME. A More Conservative Approach in the Surgical Management of Pediatric Physeal Ankle Fractures Should be Preferred: Mid to Long-term Functional Outcomes of Three Different Surgical Techniques for Salter-Harris Type II and Triplane Distal Tibial Fractures. J Pediatr Orthop 2023; 43:e734-e741. [PMID: 37470086 DOI: 10.1097/bpo.0000000000002471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Pediatric physeal ankle fractures carry a high risk of complications. This study aimed to (1) investigate the effect of anatomic reduction of the physis on mid to long-term functional outcomes in Salter-Harris type II and triplane distal tibial physeal fractures (DTPFs) and (2) compare the outcomes of 3 different surgical techniques applied in these fractures. METHODS The database of a single level-I trauma center was retrospectively reviewed for DTPFs between 2012 and 2022. A total of 39 eligible patients with operative Salter-Harris type II and triplane fractures between 2012 and 2022 were included. Surgical treatment methods were closed reduction-percutaneous fixation (CR-PF), open reduction-screw fixation, or open reduction-plate fixation. Patients were further divided into subgroups for fractures reduced anatomically (<1 mm) or nonanatomically (1 to 3 mm). The primary outcome measures were the American Orthopaedic Foot and Ankle Society Score, ankle range of motion, presence of premature physeal closure and angular deformities, and Takakura ankle osteoarthritis grade. RESULTS A total of 39 patients were included, with an average age of 12.9 ± 2.2 years. The mean follow-up time was 68.9±38.0 months. The CR-PF group had higher postoperative fracture displacement ( P = 0.011). American Orthopaedic Foot and Ankle Society scores were excellent in all groups, statistically similar between surgical techniques, and similar between anatomic and nonanatomic reduction groups. The CR-PF group ( P =0.030) and nonanatomic reduction ( P = 0.030) provided a significantly lower ankle osteoarthritis rate. All 4 patients with premature physeal closure were observed in patients treated with open techniques. CONCLUSIONS CR-PF for the treatment of DTPFs should be preferred in suitable cases as it is less invasive and provides satisfactory mid to long-term functional outcomes without increasing complications compared with anatomic reduction and open techniques. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Tolga Onay
- Department of Orthopaedics and Traumatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University
| | - Zekeriya Ersin Çelen
- Department of Orthopaedics and Traumatology, Kartal Dr. Lütfi Kirdar City Hospital, University of Health Sciences, Istanbul
| | - Mazlum Bayhan
- Department of Orthopaedics and Traumatology, Yalova State Hospital, Yalova, Turkey
| | - İbrahim Kandemir
- Department of Orthopaedics and Traumatology, Yalova State Hospital, Yalova, Turkey
| | - Nazim Canberk Kiliç
- Department of Orthopaedics and Traumatology, Yalova State Hospital, Yalova, Turkey
| | - Mahmut Enes Kayaalp
- Department of Orthopaedics and Traumatology, Yalova State Hospital, Yalova, Turkey
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Wu X, Xia J, Li J, Sun J, Shen X. Distal femoral physeal fractures after neonatal osteomyelitis: A case report. Medicine (Baltimore) 2019; 98:e15396. [PMID: 31045792 PMCID: PMC6504310 DOI: 10.1097/md.0000000000015396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The physeal separations and septic osteomyelitis in newborns are unusual, which represents a challenging problem in diagnosis and treatment. PATIENT CONCERNS A 2-day-old mature male suddenly complained by parents about minimal swelling around the left knee, decreased left extremity motion and no fever. DIAGNOSIS Preliminary x-rays of the lower extremities demonstrated a displaced distal femoral physeal, Laboratory investigation indicated infection. Magnetic resonance imaging and ultrasound showed displaced distal femoral physeal. A needle aspiration confirmed the diagnosis. INTERVENTION Debridement and ultrasound guide reduction with pinning of physeal separations was performed. OUTCOME At 5 years later, his last follow-up showed that there was only 1.6 cm limb-length discrepancy without angular deformity, the child did not report any pain and was perfectly able to perform his daily activities. LESSONS Distal femoral physeal fractures after neonatal osteomyelitis requires immediate and reliable decision for management. We point out the important role of the application of sonography, which is helpful to make an early diagnosis and guide reduction and percutaneous pinning of distal femoral physeal fractures.
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Affiliation(s)
- Xing Wu
- Department of Pediatric Orthopedic Surgery
| | | | - Jun Li
- Department of Pediatric Orthopedic Surgery
| | - Jie Sun
- Department of Ultrasonics, Wuhan Children's Hospital; Tongji Medical College, Huazhong University of Science & Technology, Wuhan, P. R. China
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Ropri A, Badar Z, Khan A, Murtaza H, Jetty S, Chu J, Yegorov A. Pathogenesis And Radiological Findings In Rare Case Of Salter Harris Type I Distal Tibial Fracture With Associated Osteonecrosis In The Paediatric Population. J Ayub Med Coll Abbottabad 2018; 30:463-467. [PMID: 30465386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Salter-Harris type I fractures of the distal tibia are commonly seen in paediatrics and management of such fractures follows an algorithm established in the literature. Despite this, osteonecrosis of the distal tibia can subsequently develop. Osteonecrosis or avascular necrosis is cell death that occurs secondary to trauma, metabolic disturbances, sickle cell disease, or medication side effect. It most frequently affects the femur, talus, or humerus, and rarely the tibia. Radiographs and MRI are pivotal in making a timely diagnosis in order to minimize patient discomfort. To the best of our knowledge, there has only been one previous documented case of osteonecrosis following a Salter Harris Type I distal tibial fracture. Here, we present the second such case.
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Affiliation(s)
| | - Zain Badar
- SUNY Upstate Medical University, United States
| | - Asad Khan
- SUNY Upstate Medical University, United States
| | | | | | - Jason Chu
- SUNY Upstate Medical University, United States
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