Lower Extremity Fractures In Hospitalized Pediatric Patients Following Road Traffic Accidents - The 36th Annual Meeting of the Israel Orthopaedic Association 2016, November 30-2 December, 2016, David InterContinental, Tel Aviv, Israel

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¹Department of orthopedic surgery, Chaim Sheba medical center at Tel Hashomer, Israel
²Tel Hashomer, National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Israel
³Department of Orthopedics, Emory University School Medicine, USA
⁴Orthopedic Division,, Tel Aviv Sourasky medical center, Israel

Background: Lower extremity fractures (LEF) caused by road traffic accidents (RTA) can result in significant morbidity, and account for a substantial part of non-fatal injuries requiring hospitalization. This study investigated the epidemiology of these injuries in pediatric population.

Methods: Data from a National Trauma Registry were reviewed for RTA hospitalized patients. Between 1998 to 2014, total of 28924 pediatric (age 0-16) patients were reviewed. Data were analyzed according to mechanism of injury, age, fracture types, associated injuries, surgical treatment and their interrelations.

Results: In total 4970 (17.18%) sustained LEFs, with the highest risk in motorcycle associated RTA (33%), followed by pedestrians (26%). One out of four of patients had multiple LEFs.
40% sustained additional injuries with the highest risk in Car associated RTA (61% p<0.0001), followed by pedestrians and motorcycles (46 - 45%, p<0.0001). Overall, head/neck/face injuries were the most common associated injuries. The tibia was the most fractured bone (42%) followed by the femur (17%), fibula (17%), foot (8%) and ankle (7%). About 40% of patients required fracture treatment in an operating room (OR). As patients were older, the greater the chance they required further treatment in the OR (p<0.0001). Type of surgical treatment varied according to fracture type.

Conclusions: This study provides unique information on epidemiological characteristics of LEF, pertinent both to medical care providers, as well as to health policy-makers allocating resources and formulating prevention strategies in the attempt to deal with the burden of road traffic accidents.