O Ndour, N Ndoye, D Alumeti, M Fall, A Faye Fall, C Diouf, G Ngom, M Ndoye
O Ndour, N Ndoye, D Alumeti, M Fall, A Faye Fall, C Diouf, G Ngom, M Ndoye. Epidemiology Of Elbow Fractures In Children In The African Context: About 465 Cases.. The Internet Journal of Orthopedic Surgery. 2012 Volume 19 Number 3.
Fractures of the elbow represent for most Europeans authors [1, 2, 3] between 12% and 16% of fractures of the child. They rank third after fractures of the distal end of the two bones of the forearm and the hand . These elbow fractures are more common in boys with a peak incidence between 5 and 10 years . They occur most often at the waning of a fall in an accident and playful. Supracondylar lesions are most common. In the literature, studies focusing on the epidemiological aspect of elbow fractures in children are rare.
In Senegal there is no study about the epidemiology of elbow fractures in children thus the aim of this study whose main objective was to determine the epidemiological profile of fractures of the elbow in children at CHU Aristide Le Dantec in Dakar.
Patients and methods
Our work is a retrospective study conducted from May 1, 2003 to April 30, 2011 for the period of eight (8) years. We collected 465 cases of children with a broken elbow and who were managed at the department of surgical emergency and Paediatric Surgery of Aristide Le Dantec Hospital in Dakar.
For each case, the following parameters were studied to know the frequency, age, sex, geographic origin, circumstances of occurrence, the mechanism, the side sustained, the anatomical lesion, and associated lesions.
Patients that did not combine all these parameters were excluded from our study. We then compared our results with literature data. The data were processed with Microsoft Office Excel 2007.
In a period of 8 years we have identified 465 cases of elbow fractures with an annual incidence of 58.12.
During our study period, 1510 fractures in children were recorded. Fractures of the elbow
The average age of children was 7 years ranging from 9 months to 15 years. A peak incidence was noted in the age group of 4 to 6 years (Figure 1).
Male predominance was noted with
the majority of children came from the suburbs of Dakar with
The circumstances of occurrence
The occurrence circumstances of the elbow fracture are most frequent in recreational accidents with
fall was the most common mechanism with
Clinical and biological aspects.
Injury sustained side
left elbow fractures occurred in
The anatomical lesions
The supracondylar fractures were most common
Associated injuries accounted for
Houshian et al.  Denmark, had compiled over a period of 5 years, 355 fractures of the elbow is an annual incidence of 71. Landin  in Sweden, had recorded over 10 years, 589 fractures of the elbow is an annual incidence of 58.9. Marchand et al  in France, found an annual incidence of 40 fractures of the elbow. Our annual incidence was 58.12. These figures show that the annual incidence varies from one country to another. This can be explained by the fact that the geographic areas, demographics, climate, social life and social structures differ from one part of the world to another. Elbow fractures account for most European authors [2, 3, 4] between 8 and 16% of all fractures in children. They come in third place after fractures of the wrist and carpal and hand . However in our study, unlike these European studies, they come in the second position after fractures of the femur. Combined fractures of the wrist and hand represented less than 9% of all fractures.
According Keyboard 's climate would also intervene. Thus, according to the frequency of accidents is higher in temperate countries than in countries with harsher climate where outdoor activities are less frequent. This would also explain the higher incidence of fractures in the summer. Houshian  had also made the same observation. However in our study the highest frequency was observed during the dry season.
The male was reported in the literature by many authors [3, 6, 7] with figures ranging between 60 and 62% for male children. In our study we found that dominance with a higher number of boys with 78.27%. By cons Houshian  in his series had found a female predominance.
In our study the mean age was 7 years with a peak incidence between 4 and 6 years. Houshian et al  had returned identical figures with an average age of 7.9 years and a peak incidence between 4 and 6 years. The literature review shows that the peak incidence is between 4 and 9 years, but no explanation has been given [1-6].
Clinical and biological aspects
Circumstances and mechanisms of occurrence vary from series to series. In European studies [4, 5] domestic accidents and sports injuries are in the foreground. In the study by Landin , fractures of the elbow occurred in 10% of cases when practicing sports, 8% during the practice bike and only 2% during an accident in the street with participation a car. However in the study of Marchand  they occurred in 24% of the time when domestic accidents, while 16% of sports injuries, accidents at 3% and 1% of bicycle accidents in the street . In the study of Houshian  sports accidents were more frequent with 49.6% of cases. In our study recreational accidents are the greatest purveyors of elbow fractures in children with
Fractures of the elbow are the most frequent after fractures of the femur in our context. They mostly concern boys with a peak incidence between 4 and 6 years. These fractures occur at the waning of a fall in an accidental playful and often reach the left elbow. Associated injuries are rare and are only bone.