SA Orthopaedic Journal
On-line version ISSN 2309-8309
Print version ISSN 1681-150X
Femur shaft fractures constitute 21.9% of the orthopaedic fractures seen in our unit. The epidemiology is well described in literature from developed countries. To assess the epidemiology in a developing country and to identify socio-demographic risk factors, we did a retrospective study of 759 children with femur fractures treated over a 5-year period. We utilised the Census of 2011 to calculate the annual incidence. The socio-economic status was determined by means of a social deprivation category based on the parental occupation obtained from the Census as per the parental address. The mean annual incidence of 152 patients with femur fractures extrapolated to 0.25 per 1 000 children per year. The commonest mechanism of injury was a fall (39%) with a peak at 2 to 3 years of age, followed by motor vehicle accident (MVA) (33.7%), of which 88% were pedestrian (PVA). Ninety per cent of the patients were from the lowest two socioeconomic classes. The peak incidence at 4 to 5 years due to a PVA was younger than the >6 years reported from developed countries. Children at 4 to 5 years have not developed the cognitive and perceptuo-motor abilities to adapt to a traffic environment. The peak of 4 to 5 years due to PVAs is the result of lack of guided parental training, adequate supervision and play area in the lower socio-economic classes. In children <1 year of age, 59.3% were due to non-accidental injury (NAI) and 23.7% due to osteogenesis imperfecta.
Keywords : epidemiology; femur shaft fractures; children.