Pediatric foot fractures on radiographs: distribution and predictors of surgery
Purpose To examine the distribution and characteristics of pediatric foot fractures on radiographs with respect to age and skeletal maturation, and to identify predictors of surgery. Methods This retrospective study included children (≤ 18 years) with foot fractures, who underwent radiographic exami...
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| Veröffentlicht in: | Emergency radiology 2024-06, Vol.31 (3), p.341-348 |
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| creator | Fanney, Lewis Patel, Vandan Tariq, Shahwar M. Hong, Shijie Davidson, Richard Nguyen, Jie C. |
| description | Purpose
To examine the distribution and characteristics of pediatric foot fractures on radiographs with respect to age and skeletal maturation, and to identify predictors of surgery.
Methods
This retrospective study included children (≤ 18 years) with foot fractures, who underwent radiographic examinations (2020–2022). Electronic medical records were reviewed to obtain demographic and clinical data. Fracture characteristics, including anatomic location, presence of displacement, angulation, articular involvement, and, if skeletally immature, physeal involvement and Salter-Harris fracture pattern were collected. Logistic regression models were used to identify predictors of surgery.
Results
1,090 (596-boys, 494-girls; mean age, 11.0 ± 4.0 years) patients with 1,325 (59.8% metatarsal, 33.8% phalangeal, and 6.4% tarsal) fractures were included. Fractures of 1st metatarsal were more common among younger children whereas fractures of 2nd-4th and 5th metatarsals were more common among older children (median ages: 5.9 years vs. 10.3 years and 12.4 years,
p
|
| doi_str_mv | 10.1007/s10140-024-02230-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3043780750</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3043780750</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-4330e56a16a808f0324af9c3b0444d2e1a97500c404a2c9f517532e6c43d62483</originalsourceid><addsrcrecordid>eNp9kMlOwzAQhi0EoqXwAhxQJC5cAuMlTsINVWxSpXKAs-U6dknVxsFODn17BlIWceDgRZpv_hl9hJxSuKQA-VWkQAWkwAQexiEVe2RMBS9SvLL9X_8ROYpxBQCylMUhGfFCCiEyOibzJ1vVugu1SZz3XeKCNl0fbEx8kwRd1X4ZdPsar5Oqjogt-q7Gim6qpA3YajofkHVJ7MPShu0xOXB6He3J7p2Ql7vb5-lDOpvfP05vZqnhTHap4BxsJjWVuoDCAWdCu9LwBeBeFbNUl3kGYAQIzUzpMppnnFlpBK8kEwWfkIshtw3-rbexU5s6Grte68b6PioOgucFYAii53_Qle9Dg9shJUEKTtHehLCBMsHHGKxTbag3OmwVBfWhWw26FepWn7qVwKazXXS_2Njqu-XLLwJ8ACKWGhT0M_uf2Hf_UYkE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3060643122</pqid></control><display><type>article</type><title>Pediatric foot fractures on radiographs: distribution and predictors of surgery</title><source>Springer Online Journals Complete</source><creator>Fanney, Lewis ; Patel, Vandan ; Tariq, Shahwar M. ; Hong, Shijie ; Davidson, Richard ; Nguyen, Jie C.</creator><creatorcontrib>Fanney, Lewis ; Patel, Vandan ; Tariq, Shahwar M. ; Hong, Shijie ; Davidson, Richard ; Nguyen, Jie C.</creatorcontrib><description>Purpose
To examine the distribution and characteristics of pediatric foot fractures on radiographs with respect to age and skeletal maturation, and to identify predictors of surgery.
Methods
This retrospective study included children (≤ 18 years) with foot fractures, who underwent radiographic examinations (2020–2022). Electronic medical records were reviewed to obtain demographic and clinical data. Fracture characteristics, including anatomic location, presence of displacement, angulation, articular involvement, and, if skeletally immature, physeal involvement and Salter-Harris fracture pattern were collected. Logistic regression models were used to identify predictors of surgery.
Results
1,090 (596-boys, 494-girls; mean age, 11.0 ± 4.0 years) patients with 1,325 (59.8% metatarsal, 33.8% phalangeal, and 6.4% tarsal) fractures were included. Fractures of 1st metatarsal were more common among younger children whereas fractures of 2nd-4th and 5th metatarsals were more common among older children (median ages: 5.9 years vs. 10.3 years and 12.4 years,
p
< 0.001). Intra-articular fractures were more common among maturing and mature than immature bones (25.3% and 20.4% vs. 9.9%,
p
< 0.001). Physeal involvement was uncommon (162/977, 16.6%) and the most common pattern was Salter-Harris type II (133/162, 82.1%). A minority (47/1090, 4.3%) of patients required surgery and independent predictors of surgery included physeal involvement (OR = 5.12, 95% CI: 2.48–10.39,
p
< 0.001), multiple fractures (OR = 3.85, 95% CI: 1.67–8.53,
p
= 0.001), fracture displacement (OR = 9.16, 95% CI:4.43–19.07,
p
< 0.001), and articular involvement (OR = 2.72, 95% CI:1.27–5.72,
p
= 0.008). Using these predictors, the likelihood for surgery ranged between 8.0% with 1 and 86.7% with 3 predictors.
Conclusion
Pediatric foot fracture patterns differed based on age and regional skeletal maturation. Physeal involvement, multiple fractures, fracture displacement, and articular involvement were independent predictors of surgery in our study group.</description><identifier>ISSN: 1438-1435</identifier><identifier>ISSN: 1070-3004</identifier><identifier>EISSN: 1438-1435</identifier><identifier>DOI: 10.1007/s10140-024-02230-4</identifier><identifier>PMID: 38644451</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Age ; Bones ; Children ; Electronic health records ; Emergency Medicine ; Fractures ; Imaging ; Maturation ; Medicine ; Medicine & Public Health ; Original Article ; Pediatrics ; Radiographs ; Radiology ; Regression models ; Surgery</subject><ispartof>Emergency radiology, 2024-06, Vol.31 (3), p.341-348</ispartof><rights>The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER) 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-4330e56a16a808f0324af9c3b0444d2e1a97500c404a2c9f517532e6c43d62483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10140-024-02230-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10140-024-02230-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38644451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fanney, Lewis</creatorcontrib><creatorcontrib>Patel, Vandan</creatorcontrib><creatorcontrib>Tariq, Shahwar M.</creatorcontrib><creatorcontrib>Hong, Shijie</creatorcontrib><creatorcontrib>Davidson, Richard</creatorcontrib><creatorcontrib>Nguyen, Jie C.</creatorcontrib><title>Pediatric foot fractures on radiographs: distribution and predictors of surgery</title><title>Emergency radiology</title><addtitle>Emerg Radiol</addtitle><addtitle>Emerg Radiol</addtitle><description>Purpose
To examine the distribution and characteristics of pediatric foot fractures on radiographs with respect to age and skeletal maturation, and to identify predictors of surgery.
Methods
This retrospective study included children (≤ 18 years) with foot fractures, who underwent radiographic examinations (2020–2022). Electronic medical records were reviewed to obtain demographic and clinical data. Fracture characteristics, including anatomic location, presence of displacement, angulation, articular involvement, and, if skeletally immature, physeal involvement and Salter-Harris fracture pattern were collected. Logistic regression models were used to identify predictors of surgery.
Results
1,090 (596-boys, 494-girls; mean age, 11.0 ± 4.0 years) patients with 1,325 (59.8% metatarsal, 33.8% phalangeal, and 6.4% tarsal) fractures were included. Fractures of 1st metatarsal were more common among younger children whereas fractures of 2nd-4th and 5th metatarsals were more common among older children (median ages: 5.9 years vs. 10.3 years and 12.4 years,
p
< 0.001). Intra-articular fractures were more common among maturing and mature than immature bones (25.3% and 20.4% vs. 9.9%,
p
< 0.001). Physeal involvement was uncommon (162/977, 16.6%) and the most common pattern was Salter-Harris type II (133/162, 82.1%). A minority (47/1090, 4.3%) of patients required surgery and independent predictors of surgery included physeal involvement (OR = 5.12, 95% CI: 2.48–10.39,
p
< 0.001), multiple fractures (OR = 3.85, 95% CI: 1.67–8.53,
p
= 0.001), fracture displacement (OR = 9.16, 95% CI:4.43–19.07,
p
< 0.001), and articular involvement (OR = 2.72, 95% CI:1.27–5.72,
p
= 0.008). Using these predictors, the likelihood for surgery ranged between 8.0% with 1 and 86.7% with 3 predictors.
Conclusion
Pediatric foot fracture patterns differed based on age and regional skeletal maturation. Physeal involvement, multiple fractures, fracture displacement, and articular involvement were independent predictors of surgery in our study group.</description><subject>Age</subject><subject>Bones</subject><subject>Children</subject><subject>Electronic health records</subject><subject>Emergency Medicine</subject><subject>Fractures</subject><subject>Imaging</subject><subject>Maturation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Radiographs</subject><subject>Radiology</subject><subject>Regression models</subject><subject>Surgery</subject><issn>1438-1435</issn><issn>1070-3004</issn><issn>1438-1435</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMlOwzAQhi0EoqXwAhxQJC5cAuMlTsINVWxSpXKAs-U6dknVxsFODn17BlIWceDgRZpv_hl9hJxSuKQA-VWkQAWkwAQexiEVe2RMBS9SvLL9X_8ROYpxBQCylMUhGfFCCiEyOibzJ1vVugu1SZz3XeKCNl0fbEx8kwRd1X4ZdPsar5Oqjogt-q7Gim6qpA3YajofkHVJ7MPShu0xOXB6He3J7p2Ql7vb5-lDOpvfP05vZqnhTHap4BxsJjWVuoDCAWdCu9LwBeBeFbNUl3kGYAQIzUzpMppnnFlpBK8kEwWfkIshtw3-rbexU5s6Grte68b6PioOgucFYAii53_Qle9Dg9shJUEKTtHehLCBMsHHGKxTbag3OmwVBfWhWw26FepWn7qVwKazXXS_2Njqu-XLLwJ8ACKWGhT0M_uf2Hf_UYkE</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Fanney, Lewis</creator><creator>Patel, Vandan</creator><creator>Tariq, Shahwar M.</creator><creator>Hong, Shijie</creator><creator>Davidson, Richard</creator><creator>Nguyen, Jie C.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20240601</creationdate><title>Pediatric foot fractures on radiographs: distribution and predictors of surgery</title><author>Fanney, Lewis ; Patel, Vandan ; Tariq, Shahwar M. ; Hong, Shijie ; Davidson, Richard ; Nguyen, Jie C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-4330e56a16a808f0324af9c3b0444d2e1a97500c404a2c9f517532e6c43d62483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age</topic><topic>Bones</topic><topic>Children</topic><topic>Electronic health records</topic><topic>Emergency Medicine</topic><topic>Fractures</topic><topic>Imaging</topic><topic>Maturation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Radiographs</topic><topic>Radiology</topic><topic>Regression models</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fanney, Lewis</creatorcontrib><creatorcontrib>Patel, Vandan</creatorcontrib><creatorcontrib>Tariq, Shahwar M.</creatorcontrib><creatorcontrib>Hong, Shijie</creatorcontrib><creatorcontrib>Davidson, Richard</creatorcontrib><creatorcontrib>Nguyen, Jie C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Emergency radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fanney, Lewis</au><au>Patel, Vandan</au><au>Tariq, Shahwar M.</au><au>Hong, Shijie</au><au>Davidson, Richard</au><au>Nguyen, Jie C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric foot fractures on radiographs: distribution and predictors of surgery</atitle><jtitle>Emergency radiology</jtitle><stitle>Emerg Radiol</stitle><addtitle>Emerg Radiol</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>31</volume><issue>3</issue><spage>341</spage><epage>348</epage><pages>341-348</pages><issn>1438-1435</issn><issn>1070-3004</issn><eissn>1438-1435</eissn><abstract>Purpose
To examine the distribution and characteristics of pediatric foot fractures on radiographs with respect to age and skeletal maturation, and to identify predictors of surgery.
Methods
This retrospective study included children (≤ 18 years) with foot fractures, who underwent radiographic examinations (2020–2022). Electronic medical records were reviewed to obtain demographic and clinical data. Fracture characteristics, including anatomic location, presence of displacement, angulation, articular involvement, and, if skeletally immature, physeal involvement and Salter-Harris fracture pattern were collected. Logistic regression models were used to identify predictors of surgery.
Results
1,090 (596-boys, 494-girls; mean age, 11.0 ± 4.0 years) patients with 1,325 (59.8% metatarsal, 33.8% phalangeal, and 6.4% tarsal) fractures were included. Fractures of 1st metatarsal were more common among younger children whereas fractures of 2nd-4th and 5th metatarsals were more common among older children (median ages: 5.9 years vs. 10.3 years and 12.4 years,
p
< 0.001). Intra-articular fractures were more common among maturing and mature than immature bones (25.3% and 20.4% vs. 9.9%,
p
< 0.001). Physeal involvement was uncommon (162/977, 16.6%) and the most common pattern was Salter-Harris type II (133/162, 82.1%). A minority (47/1090, 4.3%) of patients required surgery and independent predictors of surgery included physeal involvement (OR = 5.12, 95% CI: 2.48–10.39,
p
< 0.001), multiple fractures (OR = 3.85, 95% CI: 1.67–8.53,
p
= 0.001), fracture displacement (OR = 9.16, 95% CI:4.43–19.07,
p
< 0.001), and articular involvement (OR = 2.72, 95% CI:1.27–5.72,
p
= 0.008). Using these predictors, the likelihood for surgery ranged between 8.0% with 1 and 86.7% with 3 predictors.
Conclusion
Pediatric foot fracture patterns differed based on age and regional skeletal maturation. Physeal involvement, multiple fractures, fracture displacement, and articular involvement were independent predictors of surgery in our study group.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38644451</pmid><doi>10.1007/s10140-024-02230-4</doi><tpages>8</tpages></addata></record> |
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| subjects | Age Bones Children Electronic health records Emergency Medicine Fractures Imaging Maturation Medicine Medicine & Public Health Original Article Pediatrics Radiographs Radiology Regression models Surgery |
| title | Pediatric foot fractures on radiographs: distribution and predictors of surgery |
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