Surgical fracture repair in children on the rise

Operative treatment of children with fractures has increased substantially during the past decade. The reasons for an increased incidence of upper extremity fractures in children are unclear but may reflect changes in leisure-time activities. 

Helenius and colleagues examined data from the Finnish National Discharge Register to determine whether the incidence of fracture surgery has changed. All of the study participants were children younger than 18 years who had been hospitalized for fracture treatment between 1997 and 2006.

The incidence of fractures that required hospitalization rose to 362 per 100,000 persons in 2006 from 319 in 1997, a 13.5% increase. Most of these new fractures involved the upper extremity-chiefly, the humerus and forearm. The incidence of inpatient-managed upper extremity fractures increased by 23%; that of lower extremity and axial fractures remained constant. Most of the fractures occurred in children younger than 15 years. Overall, the number of fractures repaired surgically increased by 20%. The patient's age and location of fracture were the primary predictors of the need for surgical repair.

The authors noted that a higher level of evidence-based data about operative management of pediatric fractures is needed to allow for a critical assessment of the higher rate for these fractures.