Injury-mechanism directness as a key factor for fracture laterality in pediatric extremity fractures
- Authors
- Kim, Keong-Hwan; Jeon, Ji Young; Lee, Seonjeong; Bae, Kunhyung; Kang, Michael Seungcheol
- Issue Date
- Nov-2023
- Publisher
- Elsevier
- Keywords
- Fracture laterality; Hand and foot dominance; Injury mechanism; Pediatric trauma
- Citation
- Journal of Orthopaedic Science, v.28, no.6, pp 1379 - 1383
- Pages
- 5
- Journal Title
- Journal of Orthopaedic Science
- Volume
- 28
- Number
- 6
- Start Page
- 1379
- End Page
- 1383
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/89815
- DOI
- 10.1016/j.jos.2022.10.024
- ISSN
- 0949-2658
1436-2023
- Abstract
- Background: Associations between certain extremity fracture sites and laterality in pediatric trauma are well known, whereas the rationale for such laterality tendencies are unclear. We hypothesized that the laterality tendency of a specific fracture would be affected by directness of injury mechanism and not by the fracture site itself. Methods: We retrospectively enrolled 1382 children (aged 2–16 years) who were diagnosed with extremity fractures sustained during loss-of-balance situations and investigated the laterality tendencies (dominant vs. non-dominant extremity) of specific fracture sites. Multivariate analyses were sequentially performed to adjust for potential confounding variables-with and without injury-mechanism directness as a covariate. Results: In the upper extremities, the non-dominant side was more prone to fractures (p < 0.001), especially of the distal supracondylar humerus, radial and/or ulnar shaft, and distal radius. In the lower extremities, the dominant side was more frequently fractured (p < 0.001), especially at the tibial shaft and distal tibia. However, the predisposing effects of specific fracture sites on fracture laterality were not statistically significant when in analysis adjusted for injury-mechanism directness as a covariate. Fracture laterality was affected by whether the injury mechanism was direct or indirect. Indirect injury to the upper extremity was strongly associated with non-dominant arm injury (odds ratio 0.686 [95% CI 0.517–0.991]; p = 0.009), whereas indirect injury to the lower extremity was strongly associated with dominant leg injury (odds ratio 2.138 [95% CI 1.444–3.165]; p < 0.001). Conclusions: Injury-mechanism directness, rather than fracture site itself, is a key factor that affects fracture laterality in pediatric extremity fractures. These findings are helpful for improving our understanding of which factors may affect fracture laterality among children. © 2022
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/89815)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.