Bone Abstracts

Objectives: Fractures are common in older children. There are only few population-based studies on fractures in infants. Child abuse is a possible trauma mechanism, especially in younger children. New national guidelines for increasing awareness of child abuse and screening for suspected non-accidental traumas in Finland were given in 2003. Our goal was to establish fracture incidence and epidemiologic fracture patterns in children under the age of 1 year.

Methods: We carried out a retrospective population-based study in Helsinki, Finland. Our data consists of patients who had a fracture before the age of one year during years 1998–2012, only birth traumas were excluded. Details regarding patient demographics, fracture site, and trauma mechanism were collected. Fracture diagnosis was always confirmed radiographically.

Results: In total, 338 children (54% males) with a fracture were diagnosed during the study period in Helsinki. Of these, 209 (62%) were younger than 9 months at the time of the diagnosis. The overall annual incidence of fractures in infants was 36.4/10 000 (median, range 18.1–55.6), it was highest in 2004. During the research period, annual fracture incidence decreased by 29%, the median incidence being 44.0/10 000 per year in 1998–2006 and 25.4/10 000 per year in 2007–2012 (P=0.026).

In children aged 0–8 months, skull fractures were most common (59%) followed by clavicle (14%), and femur (12%) fractures. In children aged 9–12 months skull fractures represented 40% of cases followed by fractures in crus (21%) and antebrachium (18%).

Conclusion: The anatomic distribution of fractures is age-dependent in infants. A significant decrease in the overall annual incidence of fractures in children under 1 year of age was seen during the study period. The role of non-accidental trauma as fracture mechanism, more detailed trends, and other contributing factors remain to be elucidated in further analysis of the data.

Grants: Päivikki and Sakari Sohlberg Foundation, Foundation for Pediatric Research, Sigrid Juselius Foundation, all Helsinki, Finland.

Disclosure: The authors declared no competing interests.