title: Epidemiologic dynamics contributing to pediatric wrist fractures in the United States.
abstract: BACKGROUND
  The purpose of this study was to explore and evaluate national trends and factors contributing to pediatric wrist fractures.
  
  
  METHODS
  Over a 16-year period from January 1998 to December 2013, we identified and reviewed patients aged 0-17 years old with the primary diagnosis of wrist fracture, as evaluated in US EDs and chronicled by the National Electronic Injury Surveillance System (NEISS) database of the US Consumer Product Safety Commission. We conducted descriptive epidemiologic, bivariate, and chi-square analyses. Patients were categorized into age-defined subgroups and further stratified by sex, race, location, and consumer product/activity associated with injury.
  
  
  RESULTS
  There were 53,265 children evaluated in NEISS EDs (national estimate, 1,908,904) with wrist fractures from 1998 to 2013. Mean age was 10.9 years, with 64 % males and 36 % females. The most common locations of injury were place of recreation/sports, home, and school. The top five consumer-product-related injuries were associated with bicycles, football, playground activities, basketball, and soccer. The highest subgroup associations were with beds (0-12 months), stairs (13-36 months), playgrounds (3-5 and 6-10 years), and football (11-17 years). The greatest increase in fractures occurred between ages 0-12 and 13-36 months, with the second-largest increase between ages 3-5 and 6-10.
  
  
  CONCLUSIONS
  It is essential to develop injury prevention and safety strategies as well as identify individual risk factors for fracture, including activity, sex, and key age transitions. Surveillance is imperative to advance our understanding of these fractures, and in the future may facilitate development of research prediction tools to anticipate or prevent injury.
authors.affiliation: Department of Orthopaedic Surgery, Wayne State University, 10000 Telegraph Road, Taylor, MI 48180 USA.
authors.forename: Neil S
authors.initials: NS
authors.lastname: Shah
authors.affiliation: Department of Orthopaedic Surgery, Wayne State University, 10000 Telegraph Road, Taylor, MI 48180 USA.
authors.forename: David
authors.initials: D
authors.lastname: Buzas
authors.affiliation: Department of Orthopaedic Surgery, Wayne State University, 10000 Telegraph Road, Taylor, MI 48180 USA.
authors.forename: Ephraim M
authors.initials: EM
authors.lastname: Zinberg
keywords: Carpal fracture; Distal radius fracture; Epidemiology; NEISS; Pediatric trauma