The relationship between extremity fractures and visual impairment in childhood: A case–control study

BACKGROUND: Fractures are common extremity injuries in pediatric orthopedic practice. The aim of this study is to determine the relationship between pediatric extremity fractures and visual impairments. METHODS: Thirty pediatric patients who were admitted to the emergency and orthopedics and traumatology clinic due to an extremity fracture after a fall were included in the study. Following fracture treatment, the patients were evaluated in terms of ocular findings before discharge from the hospital. Thirty age- and sex-matched healthy children who presented to the ophthalmology department for routine care were also recruited as the control group. All participants underwent a comprehensive ophthalmologic examination, including cycloplegic refraction, visual acuity levels, and near stereoacuity measurement. RESULTS: The number of male participants was higher in both groups. There was no significant difference between the groups in terms of age and gender distribution. The most common upper extremity fractures were observed to be distal radius (52%) and distal humerus fractures (28%). The number of patients who had a refractive error that required spectacles was significantly higher in the fracture group (p=0.039). When the visual acuity levels of the better eye were evaluated, the mean visual acuity was significantly lower in the fracture group (p=0.016). The mean stereoacuity was also significantly lower in the study group (<0.001). In the binary logistic regression analysis model, low stereopsis levels were associated with the risk of pediatric extremity fractures (95% CI: 1.056–1.385; p=0.006). CONCLUSION: Our study showed that low-energy pediatric extremity fractures are more common in children with visual impairments that require treatment, and low stereopsis is a risk factor for fractures. Consequently, regular eye examinations and early treatment of visual impairments in children may help to prevent fall-related injuries.