Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 10;5(1):e001187.
doi: 10.1136/bmjpo-2021-001187. eCollection 2021.

Trends in hospital admissions for childhood fractures in England

Ben Arthur Marson  1 , Joseph C Manning  2   3 , Marilyn James  4 , Adeel Ikram  1 , David J Bryson  2 , Benjamin J Ollivere  1
Affiliations

Trends in hospital admissions for childhood fractures in England

Ben Arthur Marson et al. BMJ Paediatr Open. .

Abstract

Purpose: Fractures to the axial and appendicular skeleton are common in children causing loss of opportunities and disability. There are relatively few studies available to quantify the number of children who have their fractures diagnosed in the emergency department and are then admitted to hospital for ongoing management. The purpose of this study is to explore trends of frequency, types and age of children sustaining fractures who were admitted for intervention to National Health Service (NHS) hospitals.

Design: The study uses data from the Hospital Episode Statistics and Office for National Statistics from 2012 to 2019 to calculate the annual incidence of hospital admission for limb, spine, facial and skull fractures per 100 000 children.

Results: During 2012-2019, 368 120 children were admitted to English NHS hospitals with a fracture. 256 008 (69.5%) were upper limb fractures, 85 737 (23.3%) were lower limb fractures and 20 939 (5.7%) were skull or facial fractures. The annual incidence of upper limb fractures was highest in children aged 5-9 (348.3 per 100 000 children) and the highest incidence of lower limb fractures was in children aged 10-15 (126.5 per 100 000 children). The incidence of skull and facial fractures in preschool (age 0-4) children has been increasing at a rate of 0.629 per 100 000 children per year.

Implications: The annual incidence of hospital admission for fractures in children has been shown to be consistent for several fracture types between 2012 and 2019. An increasing trend of admissions with preschool skull fractures was observed, though the study data do not have sufficient granularity to demonstrate if this is due to changes in practice or to accidental or non-accidental causes.

Keywords: epidemiology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Trends of fracture incidence for upper limb, lower limb, skull and facial fractures and spinal fractures between 2012 and 2019. Data presented separated by the age groups of children with trends and 95% CIs calculated using a linear regression model.
Figure 2
Figure 2
Trends of fracture interventions for limb open or closed reductions, skull and facial fractures and spinal fractures between 2012 and 2019. Data presented separated by the age groups of children with trends and 95% CIs calculated using a linear regression model. Abbreviations: CR closed reduction. ORIF open reduction internal fixation
See this image and copyright information in PMC

References

    1. Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 1983;202:1–109. - PubMed
    1. Tiderius CJ, Landin L, Düppe H. Decreasing incidence of fractures in children: an epidemiological analysis of 1,673 fractures in Malmö, Sweden, 1993-1994. Acta Orthop Scand 1999;70:622–6. 10.3109/17453679908997853 - DOI - PubMed
    1. Kang MS, Kim H-S. Characteristics and trends of traumatic injuries in children visiting emergency departments in South Korea: a retrospective serial cross-sectional study using both nationwide-sample and single-institutional data. PLoS One 2019;14:e0220798. 10.1371/journal.pone.0220798 - DOI - PMC - PubMed
    1. Bergman E, Lempesis V, Nilsson Jan-Åke, et al. . Time trends in pediatric fractures in a Swedish City from 1950 to 2016. Acta Orthop 2020;91:598–604. 10.1080/17453674.2020.1783484 - DOI - PMC - PubMed
    1. Orces CH, Orces J. Trends in the U.S. childhood emergency department visits for fall-related fractures, 2001-2015. Cureus 2020;12:e11629. 10.7759/cureus.11629 - DOI - PMC - PubMed

Publication types