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Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study

BACKGROUND: A child who suffers a fracture or a soft-tissue injury at a young age faces an increased risk of subsequent injuries during childhood. This risk could be related to personal and family characteristics or to lower-than-average bone-mineral density. The purpose of this nationwide cohort st...

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Autores principales: von Heideken, Johan, Svensson, Tobias, Iversen, Maura, Ekbom, Anders, Janarv, Per-Mats
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974004/
https://www.ncbi.nlm.nih.gov/pubmed/24589362
http://dx.doi.org/10.1186/1471-2431-14-62
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author von Heideken, Johan
Svensson, Tobias
Iversen, Maura
Ekbom, Anders
Janarv, Per-Mats
author_facet von Heideken, Johan
Svensson, Tobias
Iversen, Maura
Ekbom, Anders
Janarv, Per-Mats
author_sort von Heideken, Johan
collection PubMed
description BACKGROUND: A child who suffers a fracture or a soft-tissue injury at a young age faces an increased risk of subsequent injuries during childhood. This risk could be related to personal and family characteristics or to lower-than-average bone-mineral density. The purpose of this nationwide cohort study was to estimate the association between a femur shaft fracture at a young age and the subsequent risk of hospitalization for injuries during childhood. METHODS: We compared the subsequent risk of hospitalization for injuries during childhood among 1,404 children (exposed) who were one to three years of age when they suffered a femur shaft fracture with the risk among 13,814 randomly selected, gender- and age-matched femur fracture–free children (unexposed). Hazard ratios (HRs) and 95% confidence intervals (CIs) for severe injuries defined as fractures or soft-tissue injuries requiring hospital admission were estimated in a Cox proportional hazards model. RESULTS: Exposed children exhibited no significantly increased risk of upper-extremity fractures or soft-tissue injuries during childhood, regardless of sex and follow-up time. Boys exhibited a 162% increased risk of suffering a lower leg fracture requiring hospital admission (HR?=?2.62, 95% CI: 1.45–4.71), but the refracture risk was not significant for girls 2.02 (0.58–6.97). CONCLUSIONS: We found an increased risk for subsequent fractures in the lower leg that requires inpatient care during childhood for boys, but not for girls, who were one to three years of age when they first suffered a femur shaft fracture. This increased fracture risk is probably not simply the result of greater risk-taking among boys. The explanation might relate to factors affecting the bone quality of the lower leg.
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spelling pubmed-39740042014-04-04 Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study von Heideken, Johan Svensson, Tobias Iversen, Maura Ekbom, Anders Janarv, Per-Mats BMC Pediatr Research Article BACKGROUND: A child who suffers a fracture or a soft-tissue injury at a young age faces an increased risk of subsequent injuries during childhood. This risk could be related to personal and family characteristics or to lower-than-average bone-mineral density. The purpose of this nationwide cohort study was to estimate the association between a femur shaft fracture at a young age and the subsequent risk of hospitalization for injuries during childhood. METHODS: We compared the subsequent risk of hospitalization for injuries during childhood among 1,404 children (exposed) who were one to three years of age when they suffered a femur shaft fracture with the risk among 13,814 randomly selected, gender- and age-matched femur fracture–free children (unexposed). Hazard ratios (HRs) and 95% confidence intervals (CIs) for severe injuries defined as fractures or soft-tissue injuries requiring hospital admission were estimated in a Cox proportional hazards model. RESULTS: Exposed children exhibited no significantly increased risk of upper-extremity fractures or soft-tissue injuries during childhood, regardless of sex and follow-up time. Boys exhibited a 162% increased risk of suffering a lower leg fracture requiring hospital admission (HR?=?2.62, 95% CI: 1.45–4.71), but the refracture risk was not significant for girls 2.02 (0.58–6.97). CONCLUSIONS: We found an increased risk for subsequent fractures in the lower leg that requires inpatient care during childhood for boys, but not for girls, who were one to three years of age when they first suffered a femur shaft fracture. This increased fracture risk is probably not simply the result of greater risk-taking among boys. The explanation might relate to factors affecting the bone quality of the lower leg. BioMed Central 2014-03-03 /pmc/articles/PMC3974004/ /pubmed/24589362 http://dx.doi.org/10.1186/1471-2431-14-62 Text en Copyright © 2014 von Heideken et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
von Heideken, Johan
Svensson, Tobias
Iversen, Maura
Ekbom, Anders
Janarv, Per-Mats
Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title_full Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title_fullStr Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title_full_unstemmed Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title_short Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
title_sort femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974004/
https://www.ncbi.nlm.nih.gov/pubmed/24589362
http://dx.doi.org/10.1186/1471-2431-14-62
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