TY - JOUR
T1 - Long bone fracture characteristics in children with medical conditions linked to bone health
AU - Fortin, Kristine
AU - Bertocci, Gina
AU - Nicholas, Jennifer Lynn
AU - Lorenz, Douglas John
AU - Pierce, Mary Clyde
N1 - Funding Information:
This work was support by the Ray E. Helfer Society Career Development Grant. The Ray Helfer Society had no involvement in study design, data, or writing of this report.
Funding Information:
This work was support by the Ray E. Helfer Society Career Development Grant . The Ray Helfer Society had no involvement in study design, data, or writing of this report.
Publisher Copyright:
© 2020
PY - 2020/5
Y1 - 2020/5
N2 - Background: Knowledge of fracture characteristics among children with medical conditions affecting bone could help to distinguish medical causes from child abuse. Objective: Characterize long bone fracture morphology among children diagnosed with medical conditions linked to bone health. Participants and setting: Patients <18 years at a single pediatric hospital diagnosed with a medical condition linked to bone health and ≥1 long bone fracture were studied. Methods: This retrospective medical record review categorized underlying medical diagnoses as: metabolic bone disease, genetic disorder of connective tissue, neurologic disorder and other chronic disease. A pediatric radiologist reviewed plain films to determine fracture type and location. Descriptive statistics, as well as logistic regression were used to compare fracture types by clinical characteristics. Results: Ninety-four patients were included and their diagnoses were genetic connective disorder (19; 20.2 %), metabolic bone disease (16; 17.0 %), neurologic disorder (27; 28.7 %), and other (32; 34.0 %). A total of 216 long bone fractures were sustained; 52.1 % of children had >1 long bone fracture. Of the 216 fractures, 55 (25.5 %) were in children < 1 year, 118 (54.6 %) were associated with known trauma, and 122 (56.5 %) were in non-ambulatory patients. Lower extremity fractures occurred with greatest frequency and most fractures occurred at the mid-diaphysis. Transverse was the most common fracture type in all diagnostic categories. Children with metabolic disorders had highest odds of transverse fracture (COR 3.55, CI 1.45–8.67; neurologic disorders as reference group). Conclusions: Diseases affecting bone health can influence fracture morphology. Transverse fractures were most common in bones impacted by disease.
AB - Background: Knowledge of fracture characteristics among children with medical conditions affecting bone could help to distinguish medical causes from child abuse. Objective: Characterize long bone fracture morphology among children diagnosed with medical conditions linked to bone health. Participants and setting: Patients <18 years at a single pediatric hospital diagnosed with a medical condition linked to bone health and ≥1 long bone fracture were studied. Methods: This retrospective medical record review categorized underlying medical diagnoses as: metabolic bone disease, genetic disorder of connective tissue, neurologic disorder and other chronic disease. A pediatric radiologist reviewed plain films to determine fracture type and location. Descriptive statistics, as well as logistic regression were used to compare fracture types by clinical characteristics. Results: Ninety-four patients were included and their diagnoses were genetic connective disorder (19; 20.2 %), metabolic bone disease (16; 17.0 %), neurologic disorder (27; 28.7 %), and other (32; 34.0 %). A total of 216 long bone fractures were sustained; 52.1 % of children had >1 long bone fracture. Of the 216 fractures, 55 (25.5 %) were in children < 1 year, 118 (54.6 %) were associated with known trauma, and 122 (56.5 %) were in non-ambulatory patients. Lower extremity fractures occurred with greatest frequency and most fractures occurred at the mid-diaphysis. Transverse was the most common fracture type in all diagnostic categories. Children with metabolic disorders had highest odds of transverse fracture (COR 3.55, CI 1.45–8.67; neurologic disorders as reference group). Conclusions: Diseases affecting bone health can influence fracture morphology. Transverse fractures were most common in bones impacted by disease.
KW - Bone diseases
KW - Children
KW - Fractures
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U2 - 10.1016/j.chiabu.2020.104396
DO - 10.1016/j.chiabu.2020.104396
M3 - Article
C2 - 32135374
AN - SCOPUS:85080059732
SN - 0145-2134
VL - 103
JO - Child Abuse and Neglect
JF - Child Abuse and Neglect
M1 - 104396
ER -