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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2026, Number 2

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Acta Ortop Mex 2026; 40 (2)

Relationship between traffic accidents and femur fractures in childhood in a developing country

Navarro-Vergara A, Navarro-Fretes A

Language: Spanish
References: 24
Page: 103-108
PDF size: 695.14 Kb.


ABSTRACT

Introduction: trauma accounts for 40% of deaths among young people worldwide, and it is estimated that for every death there are between three and fifty individuals living with trauma-related disabilities. In Latin America, traffic-related injuries are exponentially higher, invariably impacting on the pediatric population. Material and methods: this was a retrospective consecutive case series including all femoral fractures related to traffic accidents in pediatric patients up to 16 years of age, treated at a single tertiary trauma referral center in a developing country, from January 2022 to December 2025. Results: a total of 258 records of femoral fractures in patients under 16 years of age were analyzed, of which 128 were related to traffic accidents. In 16.4% of cases, the injured patients were vehicle drivers. The mean age was 8.9 years. The femoral shaft was affected in 78.1% of cases, and bilateral injuries occurred in 2.6%. Associated injuries were found in 66.4%, with traumatic brain injury being the most frequent. Fracture-related complications were observed at 10.1%. The average hospital stay was 9.2 days. Conclusion: femoral fractures in patients under 16 years were mainly associated with traffic accidents involving motorcycles, most frequently affecting the femoral shaft. Male patients predominated, with a high frequency of associated injuries, particularly traumatic brain injury. Intramedullary fixation was the most commonly used treatment, with a low complication rate and generally satisfactory functional outcomes.


REFERENCES

  1. Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al, editors. Disease control priorities in developing countries. 2nd ed. Washington (DC): World Bank; 2006.

  2. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859): 2163-96. Available in: https://doi.org/10.1016/S0140-6736(12)61729-2

  3. He JY, Xiao WX, Schwebel DC, et al. Road traffic injury mortality and morbidity by country development status, 2011-2017. Chin J Traumatol. 2021; 24(2): 88-93. Available in: https://doi.org/10.1016/j.cjtee.2021.01.007

  4. World Bank. Atlas of sustainable development goals 2018: from world development indicators. Washington (DC): World Bank; 2018. Available in: https://openknowledge.worldbank.org/handle/10986/29788

  5. García-Benavides P, Mora-Ríos FG, Zavala-Luna ND, Pérez-Jimenez EI, Castro-Fuentes CA. Analysis of femoral shaft fractures in the pediatric population at a tertiary care center: a longitudinal study. Emerg Care Med. 2025; 2(1): 12.

  6. Engstrom Z, Wolf O, Hailer YD. Epidemiology of pediatric femur fractures in children: the swedish fracture register. BMC Musculoskelet Disord. 2020; 21(1): 796. Available in: https://doi.org/10.1186/s12891-020-03796-z

  7. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000; 90(4): 523-6. Available in: https://doi.org/10.2105/ajph.90.4.523

  8. World Health Organization (WHO). Paraguay. Geneva: WHO; 2023. Available in: https://apps.who.int/rest/bitstreams/retrievePDF

  9. Bradshaw CJ, Bandi AS, Muktar Z, et al. International study of the epidemiology of paediatric trauma: PAPSA research study. World J Surg. 2018; 42(6): 1885-94. Available in: https://doi.org/10.1007/s00268-017-4396-6

  10. Schuetze K, Pankratz C, Schütze S, et al. Road traffic accidents, climbing frames, or trampolines: what harms children in the 2020s? Cureus. 2023; 15(3): e35781. Available in: https://doi.org/10.7759/cureus.35781

  11. Navascués JA, Matute J, Soleto J, et al. Paediatric trauma in Spain: a report from the HUGM Trauma Registry. Eur J Pediatr Surg. 2005; 15(1): 30-7. Available in: https://doi.org/10.1055/s-2004-821213

  12. Jalalvandi F, Arasteh P, Safari Faramani R, Esmaeilivand M. Epidemiology of pediatric trauma and its patterns in Western Iran: a hospital-based experience. Glob J Health Sci. 2015; 8(6): 139-46. Available in: https://doi.org/10.5539/gjhs.v8n6p139

  13. Bener A, Hussain SJ, Ghaffar A, Abou-Taleb H, Khalil M, Samson S. Femoral fractures in children related to motor vehicle injuries. J Orthop Nurs. 2007; 11(3-4): 146-50. Available in: https://doi.org/10.1016/j.joon.2007.02.014

  14. Loder RT, O'Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006; 26(5): 561-6. Available in: https://doi.org/10.1097/01.bpo.0000230335.19029.ab

  15. Naqvi G, Johansson G, Yip G, Rehm A, Carrothers A, Stohr K. Mechanisms, patterns and outcomes of paediatric polytrauma in a UK major trauma centre. Ann R Coll Surg Engl. 2017;99(1):39-45. Available in: https://doi.org/10.1308/rcsann.2016.0222

  16. Navarro VD, Navarro FA. Femoral fractures in the immature skeleton: characterization, risk factors, and treatment options in a developing country. Injury. 2023; 54 Suppl 6: 110819. Available in: https://doi.org/10.1016/j.injury.2023.05.050

  17. Brousil J, Hunter JB. Femoral fractures in children. Curr Opin Pediatr. 2013; 25(1): 52-7. Available in: https://doi.org/10.1097/MOP.0b013e32835c20e0

  18. Dong L, Wang Y, Jiao Q, Wang S. Clinical efficacy of minimally invasive elastic stable intramedullary nailing for limb long bone fractures in children. Orthop Surg. 2021; 13(4): 1336-42. Available in: https://doi.org/10.1111/os.12977

  19. Hubbard EW, Riccio AI. Pediatric orthopedic trauma: an evidence-based approach. Orthop Clin North Am. 2018; 49(2): 195-210. Available in: https://doi.org/10.1016/j.ocl.2017.11.008

  20. Kelly BA, Naqvi M, Rademacher ES, et al. Fracture table application for pediatric femur fractures: incidence and risk factors associated with adverse outcomes. J Pediatr Orthop. 2017; 37(6): e353-6. Available in: https://doi.org/10.1097/BPO.0000000000001036

  21. Jáuregui-González ME, Zazueta-Tirado JM, Gerardo-Ornelas CH. Análisis de la frecuencia de pacientes politraumatizados en accidentes en motocicleta en la población pediátrica atendida en el Hospital Pediátrico de Sinaloa entre los años 2015 y 2017. Acta Ortop Mex. 2019; 33(4): 197-203.

  22. Freitas JP, Ribeiro LA, Jorge MT. Vítimas de acidentes de trânsito na faixa etária pediátrica atendidas em um hospital universitário: aspectos epidemiológicos e clínicos. Cad Saude Publica. 2007; 23(12): 3055-60. Available in: https://doi.org/10.1590/S0102-311X2007001200028

  23. Grauberger J, O'Byrne M, Stans AA, Shaughnessy WJ, Larson AN, Milbrandt TA. Does shorter time to treatment of pediatric femur shaft fractures impact clinical outcomes? J Pediatr Orthop. 2020; 40(6): e435-9. Available in: https://doi.org/10.1097/BPO.0000000000001544

  24. Poolman RW, Kocher MS, Bhandari M. Pediatric femoral fractures: a systematic review of 2422 cases. J Orthop Trauma. 2006; 20(9): 648-54. doi: 10.1097/01.bot.0000247073.79430.87.



EVIDENCE LEVEL

IV




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