title: Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States.
abstract: BACKGROUND
  Fractures in children are an important public health issue and a frequent cause of emergency room visits. The purpose of this descriptive epidemiological study was to identify the most frequent pediatric fractures per 1000 population at risk in the United States using the 2010 National Electronic Injury Surveillance System (NEISS) database and 2010 US Census information.
  
  
  METHODS
  The NEISS database was queried for all fractures in 2010 in children between the ages of 0 and 19 years. The NEISS national estimates were compared with the 2010 US Census data to extrapolate national occurrence rates.
  
  
  RESULTS
  The annual occurrence of fractures increased from ages 0 to 14, peaking in the 10 to 14 age range (15.23 per 1000 children). The annual occurrence rate for the entire pediatric population (0 to 19 y) was 9.47 per 1000 children. Fractures of the lower arm (forearm) were the most common among the entire study population, accounting for 17.8% of all fractures, whereas finger and wrist fractures were the second and third most common, respectively. Finger and hand fractures were most common for age groups 10 to 14 and 15 to 19 years, respectively. The overall risk of a fracture occurring throughout childhood and adolescence was 180 per 1000 children, or just under 1 in every 5 children.
  
  
  CONCLUSIONS
  Pediatric fractures represent a significant proportion of pediatric emergency department visits in the United States. Children between 10 and 14 years of age have the highest risk of having fractures. Overall, forearm fractures were the most common pediatric fractures. Most pediatric fractures can be treated on outpatient basis, with only 1 of 18 fractures requiring hospitalization or observation.
  
  
  METHODS
  Level III-Retrospective comparative study.
authors.affiliation: Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, Le Bonheur Children's Hospital, Memphis, TN.
authors.forename: Sameer M
authors.initials: SM
authors.lastname: Naranje
authors.forename: Richard A
authors.initials: RA
authors.lastname: Erali
authors.forename: William C
authors.initials: WC
authors.lastname: Warner
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Sawyer
authors.forename: Derek M
authors.initials: DM
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D005383:Finger Injuries; D050723:Fractures, Bone / Q000453:epidemiology*; D006230:Hand Injuries / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D011885:Radius Fractures / Q000453:epidemiology; D012189:Retrospective Studies; D014458:Ulna Fractures / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult