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Age of children with humeral fractures

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

  • Children aged less than 15 months were more likely to sustain an abusive humeral fracture (9/25, 36%) than those aged 15-36 months (1/99, 1%) p<0.05 4
  • 74/111 of abusive humeral fractures occurred in children under one year of age 1
  • Humeral fractures in those aged less than 18 months were significantly more likely to be due to abuse than accidental injury (p<0.001); the odds ratio (OR) for abuse was 2.3 (95% confidence interval (CI) 1.3, 4.1) p=0.004 2
  • For a child aged more than 18 months with a humeral fracture the OR for abuse was 0.29 (95%CI 0.1, 0.7) p =0.005 2
  • In a study of children aged less than four years with humeral fracture, a multivariate analysis was used to develop an algorithm to identify abuse 3
  • Abused children tended to be younger than those who were accidentally injured p>0.001 3

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References

  1. Loder RT, Feinberg JR. Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids' inpatient database. Journal of Pediatric Orthopedics. 2007;27(4):421-426 [Pubmed] (Erratum in Journal of Pediatric Orthopedics. 2008;28(6):699)
  2. Pandya NK, Baldwin K, Wolfgruber H, Christian CW, Drummond DS, Hosalkar HS. Child abuse and orthopaedic injury patterns: analysis at a level I pediatric trauma center. Journal of Pediatric Orthopaedics. 2009;29(6):618-625 [Pubmed]
  3. Pandya NK, Baldwin KD, Wolfgruber H, Drummond DS, Hosalkar HS. Humerus fractures in the pediatric population: an algorithm to identify abuse. Journal of Pediatric Orthopaedics: Part B. 2010;19(6):535-541 [Pubmed]
  4. Strait RT, Seigel RM, Shapiro RA. Humeral fractures without obvious etiologies in children less than 3 years of age: when is it abuse? Pediatrics. 1995;96(4 Pt 1):667-671 [Pubmed]

 

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