Operative Treatment of Fractures in Children Is Increasing: A Population-Based Study from Finland

BackgroundEpidemiological data on the incidence of surgical treatment of pediatric fractures are sparse. Our aim was to determine the incidence of in-hospital-treated fractures and of the surgical treatment of these fractures in children and adolescents.MethodsNational Discharge Register data on pediatric fractures (in patients younger than the age of eighteen years) treated in the hospital in Finland between 1997 and 2006 were evaluated.ResultsDuring the ten-year follow-up period, the incidence (per 100,000 persons) of fractures leading to hospitalization increased by 13.5% (from 319 in 1997 to 362 in 2006; p < 0.001). This change resulted mainly from an increase in the incidence of hospital-treated upper-extremity fractures (23% increase; from 189 in 1997 to 232 in 2006). The incidence of primary fracture surgery increased by 20% (from 237 in 1997 to 284 in 2006; p < 0.001). The incidences of surgery for upper-extremity, lower-extremity, and axial fractures increased by 28%, 3.9%, and 10.7%, respectively. Within the upper-extremity-fracture group, the incremental increase was mainly due to an increase in forearm fracture surgery (62% increase; from fifty-five in 1997 to eighty-nine in 2006) (p < 0.001).ConclusionsOperative treatment of childrenʼs fractures has increased markedly during the last ten years. Evidence-based medical and economic data supporting this change in practice are sparse.