The Epidemiology of Limb Fractures in Children Admitted to an Emergency Department in Western Iran



How to Cite

Shafiei , E. ., Nademi , A. ., Ashraf Mozafari, A. ., Bastani , E. ., Kokhazadeh , T. ., Yousefi, K. ., & Sahebi , A. . (2020). The Epidemiology of Limb Fractures in Children Admitted to an Emergency Department in Western Iran. Iranian Red Crescent Medical Journal, 22(7). Retrieved from


Background: The incidence of limb fractures in children depends on environmental factors and socioeconomic backgrounds.

Objectives: This study aimed to evaluate the epidemiology of limb fractures in 1 to 15-year-old children in Ilam City, Iran. Methods: This retrospective study enrolled all children aged 15 and below admitted to the Emam Khomeini Hospital of the Ilam University of Medical Sciences between July 2012 and March 2018. Data including age, sex, injury mechanism, and injured organs were recorded in SPSS software and analyzed using a chi-square test.

Results: Out of 4877 children, 74.3% were boys, and 25.7% were girls, with the men to women ratio of 2.87 and the mean age of 9.10± 4.3 years. Elbow and forearm with 39.35% and leg with 21.61% were the most common sites of fractures. Home, street, and sports fields were the commonplaces of injury with 50.7%, 28.3%, and 7.2%, respectively. The age range of 8 - 15 years, with 3693 cases (75.72%) was the most vulnerable age group. Fractures occurred mostly in spring and summer and less frequently in the other seasons.

Conclusions: Specific attention should be paid to the home environment and its safety for controlling injuries in preschool chil-

dren. This includes increasing parents’ knowledge of preventive measures. Moreover, improving the physical condition of pave- ments and crosswalks in the streets is necessary for the prevention of injuries.



  1. Sharma PN, Bang RL, Al-Fadhli AN, Sharma P, Bang S, Ghoneim IE. Paediatric burns in Kuwait: incidence, causes and mortality. Burns. 2006;32(1):104-11.
  2. Dlj M, Jm N, Jm G, Cg M. Concurrent upper limb and hip fracture in the elderly. Injury. 2020. doi: 10.1016/j.injury.2020.02.073. [PubMed: 32089282].
  3. Behdad A, Behdad S, Hosseinpour M. Pediatric elbow fractures in a major trauma center in iran. Archives of trauma research. 2013;1(4):172-5. doi: 10.5812/atr.8098. [PubMed: 24396773].
  4. Nomura O, Ota N, Inoue N, Shimomura S. The pucker sign in children with an upper limb fracture: A case-series. Am J Emerg Med. 2018;36(4):724-6. doi: 10.1016/j.ajem.2017.08.036. [PubMed: 28826638].
  5. Kanda T, Endo N, Kondo N. Low Bone Mineral Density of the Forearm and Femur among Postmenopausal Women with Metaphyseal Comminuted Fracture of the Distal Radius. Tohoku J Exp Med. 2019;249(3):147-54. doi: 10.1620/tjem.249.147. [PubMed: 31708524].
  6. Ploegmakers JJW, Groen W, Haverlag R, Bulstra SK. Predictors for losing reduction after reposition in conservatively treated both-bone forearm fractures in 38 children. J Clin Orthop Trauma. 2020;11(2):269-74. doi: 10.1016/j.jcot.2019.04.022. [PubMed: 32099292]. [PubMed Central: PMC7026527].
  7. Khaji A, Zargar M, Karbakhsh M. Extremity fractures in children: a hospital based study in Tehran. Chin J Traumatol. 2010;13(4):217-21. [PubMed: 20670578].
  8. Mäyränpää MK, Mäkitie O, Kallio PE. Decreasing incidence and changing pattern of childhood fractures: A population‐based study. Journal of Bone Mineral Research. 2010;25(12):2752-9. doi: 10.1002/jbmr.155.
  9. Schmikli SL, Backx FJ, Kemler HJ, van Mechelen W. National survey on sports injuries in the Netherlands: target populations for sports injury prevention programs. Clin J Sport Med. 2009;19(2):101-6. doi: 10.1097/JSM.0b013e31819b9ca3. [PubMed: 19451763].
  10. Afkhami AA. Medicine and Public Health in Modern Iran: Historical and Sociological Perspectives. Iranian Studies. 2020;53(1-2):3-7. doi: 10.1080/00210862.2019.1706426.
  11. Jalili Y, Yassaghi A, Khatib MM, Golalzadeh A. Effect of transverse faults on fracture characteristics and borehole instability in the Asmari reservoir of Zagros folded belt zone, Iran. Journal of Petroleum Science Engineering. 2020;188:106820. doi: 10.1016/j.petrol.2019.106820.
  12. Parsa A, Esmaeili B, Hallaj Moghadam M, Omidi Kashani F, Dadgarmoghaddam M, Rezaeian A. Comparison of closed with open reduction in supracondylar humerous fracture. International Journal of Pediatrics. 2020.
  13. Kelishadi R, Qorbani M, Motlagh ME, Ardalan G, Moafi M, Mahmood-Arabi M, et al. Frequency, Causes, and Places of Unintentional Injuries in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study. International journal of preventive medicine. 2014;5(10):1224-30. [PubMed: 25400879].
  14. Asadi P, Asadi K, Rimaz S, Monsef-Kasmaie V, Zohrevandi B, Mohtasham-Amiri Z. Epidemiology of trauma in children admitted to Poursina teaching hospital. Journal of Guilan University of Medical Sciences. 2015;23(92):9-15.
  15. Dolatabadi AA, Mohseninia N, Amiri M, Motamed H, Asl AH. Pediatric trauma patients in Imam Hossein emergency department; an epidemiologic study. Iranian journal of emergency medicine. 2016;3(1):4-8.
  16. Mobasheri F, Azizi H, Rastbaf F. The epidemiological pattern of injuries among children under 15 years of age in Fasa in 2013. Journal of Fasa University of Medical Sciences. 2016;6(1):69-78.
  17. Tandon T, Shaik M, Modi N. Paediatric trauma epidemiology in an urban scenario in India. Journal of Orthopaedic Surgery. 2007;15(1):41-5. doi: 10.1177/230949900701500110. [PubMed: 17429116].
  18. Pandya NK, Baldwin K, Wolfgruber H, Christian CW, Drummond DS, Hosalkar HS. Child abuse and orthopaedic injury patterns: analysis at a level I pediatric trauma center. Journal of Pediatric Orthopaedics. 2009;29(6):618-25. doi: 10.1097/BPO.0b013e3181b2b3ee. [PubMed: 19700994].
  19. Mozafari J, Motamed H, Hanafi MG, Fatehifar B. The diagnostic value of neuron-specific enolase in children with mild blunt trauma requiring cranial CT scan. Open Access Emergency Medicine: OAEM. 2020;12:1. doi: 10.17795/soj-6773. [PubMed: 32021497].
  20. Jafari D, Joudi S, Panahy PHS. Clinical and Radiographic Evaluation of the Operative Treatment of Lateral Humeral Condylar Fracture in Children at Shafa Hospital, Tehran, Iran. Shafa Orthopedic Journal. 2017;4(1).
  21. Rijal A, Dhakal N. Trend of Orthopedic Trauma Patients and Seasonal Variation. Galore International Journal of Health Sciences Research. 2020;5(1):13-6.
  22. Khodayari Zarnaq R, Saadati M, Rezapour R, Baghaie H. Epidemiology of Injuries in Children Younger Than Five Years Old - Tabriz. J Comper Oediatr. 2018;9(4). e62092. doi: 10.5812/compreped.62092