Epidemiology of pediatric forearm fractures in Washington, DC.

BACKGROUND

Pediatric forearm fractures result in substantial morbidity and costs. Despite the success of public health efforts in the prevention of other injuries, the incidence of pediatric forearm fractures is increasing. Our objective is to characterize the epidemiology of forearm fractures in Washington, DC, children evaluated in an urban pediatric emergency department (ED).

METHODS

This retrospective study includes Washington, DC, children, aged 0 years to 17 years, treated for an isolated forearm fracture in the Children's National Medical Center ED from 2003 to 2006. Patients with bone mineralization disorders and repeat ED visits for the same fracture event were excluded. Chart review was done to obtain demographic and clinical data. Descriptive epidemiologic and bivariate analyses were conducted.

RESULTS

This preliminary analysis included 929 patients. The majority of patients are male (64%) and African American (80%). The mean age (± standard deviation) is 8.4 years (±3.9). Weight-for-age percentile was ≥95% in 24.1% of cases. Most forearm fractures occurred during the spring season. The most common mechanism of injury was fall-related (83%) whereas direct trauma caused 10% of fractures. "Fall from monkey bars" was the specific mechanism of injury in 17% of all cases. The majority of forearm fractures (58%) resulted from minor trauma.

CONCLUSIONS

Falls from monkey bars and minor trauma are implicated in the majority of childhood forearm fractures. The prevention strategies should target playground safety. Further research is needed to evaluate factors, including obesity and bone health, which may contribute to forearm fracture risk associated with minor trauma.