Upper extremity fractures among hospitalized pediatric road traffic accident victims

Background: Upper extremity fractures (UEFs) associated with road traffic accidents (RTAs) may result in long-term disability. Previous studies have examined UEF profiles with small patient populations. The objective of this study was to examine the injury profiles of UEFs in all mechanisms of injury related to RTAs in the pediatric population. Methods: Data on 27 831 RTA hospitalized pediatric patients between 1997 and 2012 whose records were entered in a centralized country trauma database were reviewed. Data on UEFs related to mechanism of injury (car, motorcycle, bicycle, and pedestrian) including associated injuries, multiple UEFs, and frequency of UEF were analyzed. Results: Of 27 831 pediatric RTA cases recorded in 1997-2012, 3666 (13.2%) included UEFs. Motorcycle (18%) and bicycle riders (18%) had a greater risk for UEF (P <.0001). Of 3666 patients with UEFs, 2047 (56%) had other injuries. The pedestrians (82%) and the motorcycle riders (78%) had a greater risk for associated injuries (P <.0001). Most of the injuries were head/face/neck (70%), lower extremities (36%), and chest (28%) injuries (P <.0001). Twenty-two percent of all cases had multiple UEFs. The bicycle riders (28%) had a greater risk for multiple UEFs (P <.0001). Of 3666 patients with UEFs, we found 4612 UEFs. most of the fractures in the radius (27%), humerus (25%), ulna (18%) and clavicle (17%) (P <.0001). Conclusions: This study contributes the largest database on reported pediatric UEFs related to all mechanisms of injury in RTAs and finds the comparative epidemiology of associated injuries, multiple UEFs, and frequency of UEFs.