Abstract
Introduction: There is little epidemiological data on childhood injury in Ireland, despite large numbers of referrals to fracture clinics particularly in the summer months. Information is difficult to obtain retrospectively, and our aim was to quantify paediatric injury referrals to our clinics and analyse trends in injury patterns.
Methods: A prospective injury surveillance system was initiated in our department. Parents were asked to record demographic information and a brief description of the injury at fracture clinics or admission to the ward. Diagnosis and treatment was completed by the attending doctor. Details were transferred to a customised database for analysis.
Results: Overall compliance was excellent. Of 397 recorded referrals, 66% had confirmed fractures, and 20% of these were admitted for operative management. There was an equal sex distribution, and mean age at presentation was 9.1 years. The peak hour of injury was 7 – 8 pm, with fairly even distribution throughout the week. 62% of injuries were due to falls. 39% of injuries occured in or about the home, including 61% of all falls greater than 1 metre, most often from walls and slides. Other common locations for injury were school (16%) and sportsfields (14%). Gaelic football and soccer were the predominant sports causing injury. Fractures occuring during unsupervised sport were more likely to need surgery. Road traffic accidents were an uncommon cause of injury. Home ‘bouncy castles’ and trampolines were a notable cause of injury, causing 6% of all fractures, particularly of the upper limb. Predictably, 41% of all fractures involved the radius. Fractures of the distal humerus, diaphyses of radius, ulna and tibia were most likely to need operative management.
Discussion Analysis yielded a timely insight into the local epidemiology of childhood injuries. In comparison with other studies, sports related injuries were frequent and road accidents were unusually few in our group. Many injuries occurring late in the evening needed early reduction, with almost two thirds of surgical procedures performed out of hours with significant implications on theatre and radiology staffing. A large proportion of higher energy trauma occured in or about the home, representing a potential area for injury prevention stratgies.
The abstracts were prepared by Emer Agnew, Secretary to the IOA. Correspondence should be addressed to him at Irish Orthopaedic Association Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
