The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

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State: Public
Version: Final published version
Serval ID
serval:BIB_19032941BFE4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).
Journal
Acta orthopaedica
Author(s)
Joeris A., Lutz N., Blumenthal A., Slongo T., Audigé L.
ISSN
1745-3682 (Electronic)
ISSN-L
1745-3674
Publication state
Published
Issued date
04/2017
Peer-reviewed
Oui
Volume
88
Number
2
Pages
123-128
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the upper extremities of a representative population of children classified according to the PCCF. Patients and methods - We included children and adolescents (0-17 years old) diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at the university hospitals in Bern and Lausanne (Switzerland). Patient charts were retrospectively reviewed and fractures were classified from standard radiographs. Results - Of 2,292 upper extremity fractures in 2,203 children and adolescents, 26% involved the humerus and 74% involved the forearm. In the humerus, 61%, and in the forearm, 80% of single distal fractures involved the metaphysis. In adolescents, single humerus fractures were more often epiphyseal and diaphyseal fractures, and among adolescents radius fractures were more often epiphyseal fractures than in other age groups. 47% of combined forearm fractures were distal metaphyseal fractures. Only 0.7% of fractures could not be classified within 1 of the child-specific fracture patterns. Of the single epiphyseal fractures, 49% were Salter-Harris type-II (SH II) fractures; of these, 94% occurred in schoolchildren and adolescents. Of the metaphyseal fractures, 58% showed an incomplete fracture pattern. 89% of incomplete fractures affected the distal radius. Of the diaphyseal fractures, 32% were greenstick fractures. 24 Monteggia fractures occurred in pre-school children and schoolchildren, and 2 occurred in adolescents. Interpretation - The pattern of pediatric fractures in the upper extremity can be comprehensively described according to the PCCF. Prospective clinical studies are needed to determine its clinical relevance for treatment decisions and prognostication of outcome.

Keywords
Adolescent, Age Distribution, Body Mass Index, Child, Child, Preschool, Comorbidity, Diaphyses/diagnostic imaging, Diaphyses/injuries, Epiphyses/diagnostic imaging, Epiphyses/injuries, Female, Humans, Humeral Fractures/classification, Humeral Fractures/diagnostic imaging, Humeral Fractures/epidemiology, Infant, Infant, Newborn, Male, Obesity/epidemiology, Overweight/epidemiology, Radiography, Radius Fractures/classification, Radius Fractures/diagnostic imaging, Radius Fractures/epidemiology, Retrospective Studies, Switzerland/epidemiology, Thinness/epidemiology, Ulna Fractures/classification, Ulna Fractures/diagnostic imaging, Ulna Fractures/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
06/12/2016 20:22
Last modification date
20/08/2019 12:49
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