{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:26:17Z","timestamp":1792686377585,"version":"4.5.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies, mainly single-center, on pediatric forearm fractures have shown that boys sustain fractures more frequently than girls. The most common injury mechanisms are falls and fractures occur more frequently during the summer. Most pediatric forearm fractures are treated non-surgically. This observational study aimed to present the demographics of pediatric forearm fractures in Sweden using the Swedish Fracture Register (SFR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included pediatric patients\u2009&lt;\u200916 years with a registered forearm fracture in the SFR between January 1st, 2015, and December 31st, 2019. We analyzed age, sex, injury mechanisms, anatomical location of the fracture, type of fracture, and initial treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 26,587 patients with 27,987 forearm fractures. Boys sustained a forearm fracture more frequently than girls. The boys were also significantly older. The mean age of all patients was 9.6 years. Distal fractures were most common, followed by diaphyseal and proximal fractures. Most of the fractures were torus fractures sustained to the distal radial metaphysis. Falls were the dominating injury mechanism. Most of the fractures occurred during playtime or sports activities. The most common injury place was registered as \u201cunspecified\u201d, followed by \u201csports facilities\u201d. The highest fracture occurrence was observed during the summer. Most of the fractures were treated non-surgically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Forearm fractures are a common injury in children, with 75% affecting the distal forearm. The dominant injury mechanism was falls, regardless of age. Both sex and age affect the risks of sustaining a fracture, with boys and older children being at a greater risk. Our findings highlight the need for strengthened safety measures together with fall education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-02986-5","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T11:23:13Z","timestamp":1763983393000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Epidemiology and treatment of forearm fractures in Swedish children and adolescents"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0959-3485","authenticated-orcid":false,"given":"Yasmin D.","family":"Hailer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moa","family":"Elvefors Wallin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6668-8715","authenticated-orcid":false,"given":"Olof","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"12","key":"2986_CR1","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1359\/jbmr.040902","volume":"19","author":"C Cooper","year":"2004","unstructured":"Cooper C, Dennison EM, Leufkens HG, Bishop N, Staa TP. Epidemiology of childhood fractures in Britain: a study using the general practice research database. J Bone Miner Res. 2004;19(12):1976\u201381.","journal-title":"J Bone Miner Res"},{"issue":"3 Pt 1","key":"2986_CR2","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1542\/peds.113.3.522","volume":"113","author":"DW Spady","year":"2004","unstructured":"Spady DW, Saunders DL, Schopflocher DP, Svenson LW. Patterns of injury in children: a population-based approach. Pediatrics. 2004;113(3 Pt 1):522\u20139.","journal-title":"Pediatrics"},{"issue":"1","key":"2986_CR3","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3109\/17453671003628780","volume":"81","author":"EM Hedstr\u00f6m","year":"2010","unstructured":"Hedstr\u00f6m EM, Svensson O, Bergstr\u00f6m U, Michno P. Epidemiology of fractures in children and adolescents. Acta Orthop. 2010;81(1):148\u201353.","journal-title":"Acta Orthop"},{"key":"2986_CR4","doi-asserted-by":"publisher","first-page":"115498","DOI":"10.1016\/j.bone.2020.115498","volume":"144","author":"F Song","year":"2021","unstructured":"Song F, Zeng Y, Tian J, Lv Y, Feng G, Ni X. Epidemiology and the economic burden of pediatric fractures in China: a retrospective study of 14,141 fractures. Bone. 2021;144:115498.","journal-title":"Bone"},{"issue":"6","key":"2986_CR5","doi-asserted-by":"publisher","first-page":"622","DOI":"10.3109\/17453679908997853","volume":"70","author":"CJ Tiderius","year":"1999","unstructured":"Tiderius CJ, Landin L, Duppe H. Decreasing incidence of fractures in children: an epidemiological analysis of 1,673 fractures in Malmo, Sweden, 1993\u20131994. Acta Orthop Scand. 1999;70(6):622\u20136.","journal-title":"Acta Orthop Scand"},{"key":"2986_CR6","unstructured":"Socialstyrelsen. Statistical Database, Diagnoses: National Board of Health and Welfare (Socialstyrelse); [Available from: https:\/\/sdb.socialstyrelsen.se\/if_par\/val_eng.aspx"},{"issue":"6","key":"2986_CR7","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1302\/2633-1462.36.BJO-2022-0040.R1","volume":"3","author":"LR Korup","year":"2022","unstructured":"Korup LR, Larsen P, Nanthan KR, Arildsen M, Warming N, S\u00f8rensen S, et al. Children\u2019s distal forearm fractures: a population-based epidemiology study of 4,316 fractures. Bone Joint Open. 2022;3(6):448\u201354.","journal-title":"Bone Joint Open"},{"issue":"2","key":"2986_CR8","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1097\/01202412-199704000-00002","volume":"6","author":"LA Landin","year":"1997","unstructured":"Landin LA. Epidemiology of children\u2019s fractures. J Pediatr Orthop B. 1997;6(2):79\u201383.","journal-title":"J Pediatr Orthop B"},{"issue":"8","key":"2986_CR9","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/j.injury.2007.01.036","volume":"38","author":"L Rennie","year":"2007","unstructured":"Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007;38(8):913\u201322.","journal-title":"Injury"},{"key":"2986_CR10","unstructured":"Lund AR, Faergemann C, Lauritsen JM. A population-based study of seasonal variation in children\u2019s fractures. Dan Med J. 2021;68(10)."},{"key":"2986_CR11","doi-asserted-by":"publisher","first-page":"116479","DOI":"10.1016\/j.bone.2022.116479","volume":"162","author":"A Morohoshi","year":"2022","unstructured":"Morohoshi A, Qureshi AR, Iseri K, Morohoshi H, Li Y, Lindholm B, et al. Secular trends in incidence and seasonal variation of distal radius fracture among children: a nationwide study based on the Swedish National patient register 2002\u20132016. Bone. 2022;162:116479.","journal-title":"Bone"},{"issue":"6","key":"2986_CR12","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1302\/1863-2548.12.180114","volume":"12","author":"D Segal","year":"2018","unstructured":"Segal D, Slevin O, Aliev E, Borisov O, Khateeb B, Faour A, et al. Trends in the seasonal variation of paediatric fractures. J Child Orthop. 2018;12(6):614\u201321.","journal-title":"J Child Orthop"},{"issue":"3","key":"2986_CR13","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1302\/1863-2548.11.170017","volume":"11","author":"AI Cruz Jr.","year":"2017","unstructured":"Cruz AI Jr., Kleiner JE, DeFroda SF, Gil JA, Daniels AH, Eberson CP. Increasing rates of surgical treatment for paediatric diaphyseal forearm fractures: a national database study from 2000 to 2012. J Child Orthop. 2017;11(3):201\u20139.","journal-title":"J Child Orthop"},{"issue":"2","key":"2986_CR14","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1177\/1457496920983104","volume":"110","author":"JJ Sinikumpu","year":"2021","unstructured":"Sinikumpu JJ, Nietosvaara Y. Treatment of distal forearm fractures in children. Scand J Surg. 2021;110(2):276\u201380.","journal-title":"Scand J Surg"},{"issue":"2","key":"2986_CR15","first-page":"5325","volume":"6","author":"ML Vopat","year":"2014","unstructured":"Vopat ML, Kane PM, Christino MA, Truntzer J, McClure P, Katarincic J, et al. Treatment of diaphyseal forearm fractures in children. Orthop Rev. 2014;6(2):5325.","journal-title":"Orthop Rev"},{"key":"2986_CR16","doi-asserted-by":"publisher","first-page":"32","DOI":"10.2340\/17453674.2023.7132","volume":"94","author":"RT Hansen","year":"2023","unstructured":"Hansen RT, Borghegn NW, Gundtoft PH, Nielsen KA, Balslev-Clausen A, Viberg B. Change in treatment preferences in pediatric diaphyseal forearm fractures: a Danish nationwide register study of 36,244 fractures between 1997 and 2016. Acta Orthop. 2023;94:32\u20137.","journal-title":"Acta Orthop"},{"issue":"1","key":"2986_CR17","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05062-w","volume":"23","author":"M Moller","year":"2022","unstructured":"Moller M, Wolf O, Bergdahl C, Mukka S, Rydberg EM, Hailer NP, et al. The Swedish fracture register - ten years of experience and 600,000 fractures collected in a national quality register. BMC Musculoskelet Disord. 2022;23(1):141.","journal-title":"BMC Musculoskelet Disord"},{"key":"2986_CR18","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/s12891-015-0795-8","volume":"16","author":"D Wennergren","year":"2015","unstructured":"Wennergren D, Ekholm C, Sandelin A, Moller M. The Swedish fracture register: 103,000 fractures registered. BMC Musculoskelet Disord. 2015;16:338.","journal-title":"BMC Musculoskelet Disord"},{"key":"2986_CR19","volume-title":"A Language and environment for statistical computing","author":"RC Team","year":"2023","unstructured":"Team RC. A Language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2023."},{"issue":"3","key":"2986_CR20","doi-asserted-by":"publisher","first-page":"587","DOI":"10.2106\/00004623-196345030-00019","volume":"45","author":"RHW Salter","year":"1963","unstructured":"Salter RHW. Injuries involving the epiphyseal plate. J Bone Joint Surg Am. 1963;45(3):587\u2013622.","journal-title":"J Bone Joint Surg Am"},{"key":"2986_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-656","volume":"10","author":"G Valerio","year":"2010","unstructured":"Valerio G, Galle F, Mancusi C, Di Onofrio V, Colapietro M, Guida P, et al. Pattern of fractures across pediatric age groups: analysis of individual and lifestyle factors. BMC Public Health. 2010;10:656.","journal-title":"BMC Public Health"},{"issue":"Suppl","key":"2986_CR22","first-page":"1","volume":"202","author":"LA Landin","year":"1983","unstructured":"Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950\u20131979. Acta Orthop Scand. 1983;202(Suppl):1\u2013109.","journal-title":"Acta Orthop Scand"},{"issue":"6","key":"2986_CR23","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1055\/s-0039-1692471","volume":"8","author":"V Lempesis","year":"2019","unstructured":"Lempesis V, Jerrhag D, Rosengren BE, Landin L, Tiderius CJ, Karlsson MK. Pediatric distal forearm fracture epidemiology in Malm\u00f6, Sweden-time trends during six decades. J Wrist Surg. 2019;8(6):463\u20139.","journal-title":"J Wrist Surg"},{"issue":"5","key":"2986_CR24","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1097\/BPB.0000000000000278","volume":"25","author":"A Lyman","year":"2016","unstructured":"Lyman A, Wenger D, Landin L. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications. J Pediatr Orthop B. 2016;25(5):439\u201346.","journal-title":"J Pediatr Orthop B"},{"issue":"7","key":"2986_CR25","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1007\/s00402-019-03321-5","volume":"140","author":"D Korner","year":"2020","unstructured":"Korner D, Gonser CE, Bahrs C, Hemmann P. Change in paediatric upper extremity fracture incidences in German hospitals from 2002 to 2017: an epidemiological study. Arch Orthop Trauma Surg. 2020;140(7):887\u201394.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"4","key":"2986_CR26","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1097\/BPO.0000000000000595","volume":"36","author":"SM Naranje","year":"2016","unstructured":"Naranje SM, Erali RA, Warner WC Jr., Sawyer JR, Kelly DM. Epidemiology of pediatric fractures presenting to emergency departments in the united States. J Pediatr Orthop. 2016;36(4):e45\u20138.","journal-title":"J Pediatr Orthop"},{"issue":"3","key":"2986_CR27","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1136\/ip.4.3.194","volume":"4","author":"B Kopjar","year":"1998","unstructured":"Kopjar B, Wickizer TM. Fractures among children: incidence and impact on daily activities. Inj Prev. 1998;4(3):194\u20137.","journal-title":"Inj Prev"},{"issue":"10345","key":"2986_CR28","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/S0140-6736(22)01015-7","volume":"400","author":"DC Perry","year":"2022","unstructured":"Perry DC, Achten J, Knight R, Appelbe D, Dutton SJ, Dritsaki M, et al. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. Lancet. 2022;400(10345):39\u201347.","journal-title":"Lancet"},{"key":"2986_CR29","doi-asserted-by":"publisher","DOI":"10.3390\/children9101487","author":"TR Liebs","year":"2022","unstructured":"Liebs TR, Lorance A, Berger SM, Kaiser N, Ziebarth K. Health-related quality of life after fractures of the distal forearm in children and adolescents-results from a center in Switzerland in 432 patients. Children (Basel). 2022. https:\/\/doi.org\/10.3390\/children9101487.","journal-title":"Children (Basel)"},{"issue":"5","key":"2986_CR30","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1136\/injuryprev-2017-042627","volume":"25","author":"H Carpenter","year":"2019","unstructured":"Carpenter H, Audsley S, Coupland C, Gladman J, Kendrick D, Lafond N, et al. Physical activity implementation study in Community-dwelling adults (PHISICAL): study protocol. Inj Prev. 2019;25(5):453\u20138.","journal-title":"Inj Prev"},{"issue":"1","key":"2986_CR31","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1186\/s12877-024-05382-7","volume":"24","author":"A Zanotto","year":"2024","unstructured":"Zanotto A, Zanotto T, Alexander NB, Sosnoff JJ. Views and experiences of older people taking part in a safe-falling training program: lessons learned from the falling safely training (FAST) trial. BMC Geriatr. 2024;24(1):818.","journal-title":"BMC Geriatr"},{"issue":"14","key":"2986_CR32","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1136\/bjsports-2012-091439","volume":"47","author":"J Nauta","year":"2013","unstructured":"Nauta J, Knol DL, Adriaensens L, Klein Wolt K, van Mechelen W, Verhagen EA. Prevention of fall-related injuries in 7-year-old to 12-year-old children: a cluster randomised controlled trial. Br J Sports Med. 2013;47(14):909\u201313.","journal-title":"Br J Sports Med"},{"key":"2986_CR33","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-0889","author":"N Hadley-Miller","year":"2020","unstructured":"Hadley-Miller N, Carry PM, Brazell CJ, Holmes KS, Georgopoulos G. Trends in trampoline fractures: 2008\u20132017. Pediatrics. 2020. https:\/\/doi.org\/10.1542\/peds.2019-0889.","journal-title":"Pediatrics"},{"issue":"3","key":"2986_CR34","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.injury.2011.11.006","volume":"43","author":"JJ Sinikumpu","year":"2012","unstructured":"Sinikumpu JJ, Lautamo A, Pokka T, Serlo W. The increasing incidence of paediatric diaphyseal both-bone forearm fractures and their internal fixation during the last decade. Injury. 2012;43(3):362\u20136.","journal-title":"Injury"},{"key":"2986_CR35","unstructured":"Idrottsstatistik. [Available from: https:\/\/idrottsstatistik.se\/foreningsidrott\/aktivitet-iolika-idrotter\/"},{"issue":"4","key":"2986_CR36","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1097\/01.bpb.0000271328.79481.07","volume":"27","author":"RT Loder","year":"2007","unstructured":"Loder RT, Feinberg JR. Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids\u2019 inpatient database. J Pediatr Orthop. 2007;27(4):421\u20136. https:\/\/doi.org\/10.1097\/01.bpb.0000271328.79481.07.","journal-title":"J Pediatr Orthop"},{"issue":"3","key":"2986_CR37","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1177\/1457496915594285","volume":"104","author":"JJ Sinikumpu","year":"2015","unstructured":"Sinikumpu JJ. Too many unanswered questions in children\u2019s forearm shaft fractures: high-standard epidemiological and clinical research in pediatric trauma is warranted. Scand J Surg. 2015;104(3):137\u20138.","journal-title":"Scand J Surg"},{"issue":"5","key":"2986_CR38","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1302\/0301-620X.103B.BJJ-2020-1740.R1","volume":"103\u2013b","author":"BA Marson","year":"2021","unstructured":"Marson BA, Ng JWG, Craxford S, Chell J, Lawniczak D, Price KR, et al. Treatment of completely displaced distal radial fractures with a straight plaster or manipulation under anaesthesia. Bone Joint J. 2021;103\u2013b(5):902\u20137.","journal-title":"Bone Joint J"},{"issue":"1","key":"2986_CR39","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1302\/0301-620X.106B1.BJJ-2023-1112","volume":"106\u2013b","author":"D Metcalfe","year":"2024","unstructured":"Metcalfe D, Perry DC. Surgically reducing displaced distal radial fractures in children. Bone Joint J. 2024;106\u2013b(1):16\u20138.","journal-title":"Bone Joint J"},{"key":"2986_CR40","unstructured":"SFR. T\u00e4ckningsgradsanalys Svenska Frakturregister 2024 [Available from: https:\/\/sfr.registercentrum.se\/om-registret\/taeckningsgradsanalys\/p\/HJedFyVyE"},{"key":"2986_CR41","doi-asserted-by":"publisher","first-page":"325","DOI":"10.2147\/CLEP.S307762","volume":"13","author":"C Bergdahl","year":"2021","unstructured":"Bergdahl C, Nilsson F, Wennergren D, Ekholm C, M\u00f6ller M. Completeness in the Swedish fracture register and the Swedish National patient register: an assessment of humeral fracture registrations. Clin Epidemiol. 2021;13:325\u201333.","journal-title":"Clin Epidemiol"},{"issue":"1","key":"2986_CR42","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04473-5","volume":"22","author":"M Bergvall","year":"2021","unstructured":"Bergvall M, Bergdahl C, Ekholm C, Wennergren D. Validity of classification of distal radial fractures in the Swedish fracture register. BMC Musculoskelet Disord. 2021;22(1):587.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"2986_CR43","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12891-022-05062-w","volume":"23","author":"M M\u00f6ller","year":"2022","unstructured":"M\u00f6ller M, Wolf O, Bergdahl C, Mukka S, Rydberg EM, Hailer NP, et al. The Swedish fracture register - ten years of experience and 600,000 fractures collected in a national quality register. BMC Musculoskelet Disord. 2022;23(1):141.","journal-title":"BMC Musculoskelet Disord"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-025-02986-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-025-02986-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-025-02986-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T11:04:50Z","timestamp":1770721490000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-025-02986-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2986"],"URL":"https:\/\/doi.org\/10.1007\/s00068-025-02986-5","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"26 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Swedish Ethical Review Authority (Approval No. 2019\u201304282, date of issue 10th of September 2019) and conducted in line with the Declaration of Helsinki. Informed consent was waived due to the study\u2019s register-based design. Data were sourced from a national quality register, not individual medical records, and are governed by the Swedish Patient Data Act. Patients are informed about inclusion in the register and have the right to opt out. Ethical review boards determine whether consent is required and if data must be anonymized; in this case, consent was not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"342"}}