An epidemiological evaluation of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals.

BACKGROUND Children and adolescents are at high risk of sustaining fractures during growth. Therefore, epidemiological assessment is crucial for fracture prevention. The AO Comprehensive Injury Automatic Classifier (AO COIAC) was used to evaluate epidemiological data of pediatric long bone fractures in a large cohort. METHODS Data from children and adolescents with long bone fractures sustained between 2009 and 2011, treated at either of two tertiary pediatric surgery hospitals in Switzerland, were retrospectively collected. Fractures were classified according to the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF). RESULTS For a total of 2716 patients (60% boys), 2807 accidents with 2840 long bone fractures (59% radius/ulna; 21% humerus; 15% tibia/fibula; 5% femur) were documented. Children's mean age (SD) was 8.2 (4.0) years (6% infants; 26% preschool children; 40% school children; 28% adolescents). Adolescent boys sustained more fractures than girls (p < 0.001). The leading cause of fractures was falls (27%), followed by accidents occurring during leisure activities (25%), at home (14%), on playgrounds (11%), and traffic (11%) and school accidents (8%). There was boy predominance for all accident types except for playground and at home accidents. The distribution of accident types differed according to age classes (p < 0.001). Twenty-six percent of patients were classed as overweight or obese - higher than data published by the WHO for the corresponding ages - with a higher proportion of overweight and obese boys than in the Swiss population (p < 0.0001). CONCLUSION Overall, differences in the fracture distribution were sex and age related. Overweight and obese patients seemed to be at increased risk of sustaining fractures. Our data give valuable input into future development of prevention strategies. The AO PCCF proved to be useful in epidemiological reporting and analysis of pediatric long bone fractures.

The interurban DRAG-Spain model: the main factors of influence on road accidents in Spain

This paper presents the results of applying DRAG methodology to the identification of the main factors of influence on the number of injury and fatal accidents occurring on Spain’s interurban network. Nineteen independent variables have been included in the model grouped together under ten categories: exposure, infrastructure, weather, drivers, economic variables, vehicle stock, surveillance, speed and legislative measures. Highly interesting conclusions can be reached from the results on the basis of the different effects of a single variable on each of the accident types according to severity. The greatest influence revealed by the results is exposure, which together with inexperienced drivers, speed and an ageing vehicle stock, have a negative effect, while the increased surveillance on roads, the improvement in the technological features of vehicles and the proportion of high capacity networks have a positive effect, since the results obtained show a significant drop in accidents.

Estimating the injury-reducing benefits of ejection-mitigating glazing.

Mode of access: Internet.

The role of alcohol, marijuana and other drugs in the accidents of injured drivers. [Revised edition].

National Highway Traffic Safety Administration, Washington, D.C.

Vehicle accidents in highway work zones. Final report.

Federal Highway Administration, Washington, D.C.

Exposure measures for evaluating highway safety issues. Volume I. Final report.

Federal Highway Administration, Washington, D.C.

Exposure measures for evaluating highway safety issues. Volume 2 - users manual. Final report.

Federal Highway Administration, Washington, D.C.

Accidents involving handicapped drivers. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Safety impacts of different speed limits on cars and trucks. Final report.

Federal Highway Administration, Office of Safety and Traffic Operations Research and Development, McLean, Va.

Identification of specific problems and countermeasures targets for reducing alcohol related casualties. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

A comparison alcohol involvement in pedestrian and pedestrian casualties. Executive summary.

National Highway Traffic Safety Administration, Washington, D.C.

A comparison of alcohol involvement in pedestrians and pedestrian casualties. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Highway safety: causes of injury in automobile crashes.

Mode of access: Internet.

Safe geometric design for minicars. Final report.

Federal Highway Administration, Office of Research and Development, Washington, D.C.

Statistics of truck accidents: an addendum to a study of longer and wider trucks on the Texas Highway System. Interim report.

Texas State Department of Highways and Public Transportation, Transportation Planning Division, Austin