Muhammad Saeed Minhas, Irfanullah Ansari, Khalid, Nasir Baig, Ehtasham Siddiqui.
Musculo- skeletal trauma and the epidemiology of fractures in children.
J Pak Orthop Assoc Jan ;23(1):01-6.

Objectives: The aim of this study is to review and describe the pattern of pediatric fractures Study Design: A Prospective Descriptive study. Place and Duration of Study: Accident and emergency and Department of Orthopedics, Jinnah Post Graduate Medical Centre Karachi. One year study with break ups of each month, from August 1st, 2008 to July 31st 2009 were evaluated and included in this study. Study Design: Analytical retrospective. Patients and Methods: Newborn to children 15 years of age with musculo skeletal injuries presenting to Accident and Emergency were registered in Injury surveillance Performa of Orthopaedic department. These Performa's and in patients files were evaluated to extract information concerning type of injury, bony or soft tissue, age,sex, and etiology of trauma. Difference in time of trauma and arrival to accident and emergency department. Type of initial treatment taken in case of late arrivals. Anatomical region wise distribution of trauma, associated injuries and complex injuries were evaluated. Number of children with trauma admitted and operations performed were also evaluated. Results: Children presented in orthopedics emergency room in one year with musculo skeletal trauma were 2487 which constitutes 25.54% of all musculo skeletal traumas.Average were 207 children per month, highest number was in May 259. 75% of patients were between 6 to 15 years of age. 74.7% (1859) were boys and 25.25 % (628) were girls.247 (10.33%) children presented with soft tissue injuries only. The majority of fractures in children involve the upper limbs 57.6% and major cause was fall. Lower limb fractures are mainly caused by twisting injuries and road traffic accidents which account for 16.33%. 95% of cases were managed on outpatient basis and only 90 (3.61%) were operated. 50(2%) children presented in one year with work related injuries labeled as child labor and majority of these presented with severe injuries. Admission and operation in this group was 65%. Number of patients initially went to traditional bone setters were 86 (3.45%) and reporting to hospital after average 03 days. Number of patients presented with complications were1%.The mean time to hospital presentation was 1.2 day (range 30 minutes to 45 days). Conclusion: Musculo skeletal trauma in children is more common in low socio- economic group, more in boys, in upper limb and in summer season .Higher in school going age and severe fractures and injuries in working children. This data could be used for effective local planning and evaluation of injury prevention initiatives. Mortality can be minimized by preventive measures and improvement of emergency medical services.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com