Open fractures in children: a retrospective observational study

Fractures are among the most common traumatic musculoskeletal injuries in children. A small fraction of these are open fractures. The risks of complications such as infection and soft tissue damage are suggested to be higher than closed fractures. The aim is to describe the characteristics, treatment, and outcomes of paediatric open fractures treated at a single level-1 trauma centre in the Netherlands. Patient and trauma characteristics were extracted from the Dutch National Trauma Registry, whereafter the data were completed with treatment and outcome information obtained from clinical patient records. Descriptive statistics were performed. Overall, 52 cases of paediatric open fractures were identified. The majority was male (73.1%) and the most common injury cause was a road traffic accident (55.8%), followed by low-energy falls (11.5%). Only 27.0% had an Injury Severity Score (ISS) > 15. The most frequently fractured bones were tibia (38.5%), fibula (25.0%), hand (21.2%), radius (7.7%) and ulna (7.7%). Physeal involvement was seen in 9.5%. Complications were documented in 26.9% of all patients. Infections were seen in 15.4%, malunion and non-union in 3.8% of the research population. Paediatric open fractures are relatively rare and most often occur after road traffic accidents with mostly ISS scores below 15. Physeal involvement is rare. Bone healing problems seem to be infrequent in the paediatric population. Level 4.