The Pattern of Fracture Occurrence among Children Aged 1-17 Years Presenting At Solwezi General Hospital in Solwezi District, Zambia

Abstract

Introduction: Fractures in children represent a major global health problem and account for 10- 25% of all childhood injuries. Childhood fractures are caused by falls, domestic violence and road traffic accidents. Locally, there is a paucity of data on the pattern of fracture occurrence among children in Solwezi District.

Objectives: The objectives of this study were to determine the pattern of childhood fractures in terms of the causes, severity, circumstances and geographical location in which these injuries occur, and recommend strategies for preventing these mJunes.

Materials & methods: Data collection was done using a researcher assisted questionnaire in a cross­ sectional survey and analysed using the SPSS software version 20.0 for Windows. The Chi-square test was used to test association of variables at the 0.05 level of significance.

Results: The mean age of children with fractures under review was found to be 6.88 years (SE of mean=0.453). Fractures in children were found to occur more frequently in the pre-school age group (48.3%, n=43). A male predominance in childhood fracture occurrence was noted as these fracture injuries occurred in 60.7% (n=54) of the males and 39.3% (n=35) of the females. Fractures of the upper limbs (74.2%) were more frequent than those of the lower limbs (25.8%) with the Radius (51.7%) and Ulna (22.5%) being the most frequently fractured bones. No respondent had an open fracture. Falling was the most frequent cause of injury in 73% of the respondents followed by sports injuries (13.5%). Fifty-six percent (n=50) of the fractures in children were sustained at home followed by school (16.9%) and road (19.1%). Statistically significant associations were found between respondent's age group and mechanism of injury (p-value=0.004) as well as between respondent's area of residence and geographical location ofinjury (p-value=0.005).

Conclusion: Falls are the most frequent mechanism of injury in childhood fractures seen at Solwezi General Hospital with the Radius and Ulna being the most frequently affected bones. The majority of these fractures occur at home as a result of slight trauma events. Clinically, this implies that the home advice given to patients and guardians should be tailored towards the prevention of these injuries in the settings in which they occur. General safety guidelines and policies for prevention of childhood fractures at home and in schools should be developed.