Comprehensive Patterns of Pediatric and Adolescent Upper Extremity Fractures: Age, Sex, and Seasonal Variations in a 15-Year Cohort

Background/Objectives: Pediatric upper extremity fracture patterns may differ across age groups, anatomical sites, sex, and seasons. This study aimed to describe hospital presentation patterns over 15 years, emphasizing age-specific fracture-site distributions and sex ratios. Methods: We retrospectively reviewed children aged 0–18 years presenting with upper extremity fractures between January 2010 and December 2024. Fractures were identified using International Classification of Diseases, 10th Revision codes and classified by site, age group (0–3, 4–7, 8–13, and 14–18 years), sex, season, and weekday. Analyses included chi-square tests with Cramer’s V, seasonal age comparisons with effect-size measures, and negative binomial regression of daily presentation counts adjusted for season and calendar year. Results: Among 30,526 fracture-diagnosis records, distal radius fractures were most common. The strongest overall categorical association was between fracture site and age group (Cramer’s V = 0.286), followed by age group and sex (V = 0.252). Male predominance increased with age, reaching a male/female ratio of 7.24 at 14–18 years and 19.03 for adolescent metacarpal fractures. Distal humerus fractures clustered at 4–7 years, whereas metacarpal fractures clustered in adolescence. Seasonal differences in demographic and anatomical distributions were statistically significant but small. Mean age was lowest in summer and highest in winter. Adjusted weekend presentation volume was lower than weekday volume. Conclusions: Detailed subgroup analysis reveals substantial age-, sex-, and fracture-site-specific variation. Without trauma-mechanism or population-denominator data, these findings describe hospital presentation patterns rather than causal risk estimates.