{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:29:23Z","timestamp":1783985363442,"version":"3.55.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Pediatric distal forearm fractures are one of the most common injuries seen in the emergency department. Orthopedic teaching instructs providers to radiograph the joint above and the joint below the fracture site for concurrent injury. Despite this teaching, there is little evidence to suggest that elbow injuries are common in children with distal forearm fractures. Similarly, there are few data that help the clinician predict which children are at higher risk for co-injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a cross-sectional analysis of the 2011 National Emergency Department Sample data set. Children aged 2 to 17 years with an <jats:italic toggle=\"yes\">International Classification of Disease, Ninth Revision,<\/jats:italic> code for a distal forearm fracture were included in the study. The primary outcome of interest was an \u201celbow\u201d injury, defined as an <jats:italic toggle=\"yes\">International Classification of Disease, Ninth Revision,<\/jats:italic> code for proximal radius, proximal ulna, or distal humeral fracture or dislocation. Multivariable logistic regression was performed using patient demographics, injury severity score, mechanism of injury, and underlying medical conditions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 54,262 children with a distal forearm fracture were identified. Of these children, only 0.8% (n = 463) had an elbow injury. Supracondylar fractures of the humerus were the most common elbow injury seen (48.2% of elbow injuries seen). Children were more likely to have a co-injury if they were younger (9.8 years vs 8.3 years, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01), female (36% vs 44%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01), injured via fall (68% vs 76%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01), had a higher injury severity score (4.1 vs 4.5, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01), or were admitted for their injuries (1.5% vs 15.7%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01). In the adjusted model, only age and disposition were predictors of co-injury. Isolated buckle fracture of the radius and metaphyseal fracture of the radius with dorsal angulation were protective against elbow injury (odds ratio = 0.39 and 0.60, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Children with distal forearm fractures very rarely have concurrent elbow injuries. These injuries are more likely in younger female children.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002176","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T06:00:10Z","timestamp":1594620010000},"page":"352-356","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Identifying Risk Factors for Elbow Injury in Children Presenting to the Emergency Department With Distal Forearm Fractures"],"prefix":"10.1097","volume":"37","author":[{"given":"Max","family":"Rubinstein","sequence":"first","affiliation":[{"name":"Emergency Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Hirway","sequence":"additional","affiliation":[{"name":"Pediatrics, Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Zonfrillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1359\/jbmr.040902","article-title":"Epidemiology of childhood fractures in Britain: a study using the general practice research database","volume":"19","year":"2004","journal-title":"J Bone Miner Res"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/01241398-200105000-00009","article-title":"Supracondylar fractures of the humerus associated with ipsilateral forearm fractures in children: a report of forty-seven cases","volume":"21","year":"2001","journal-title":"J Pediatr Orthop"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/BCO.0b013e318266f09f","article-title":"Current concepts in pediatric distal radial fractures","volume":"23","year":"2012","journal-title":"Curr Orthop Pract"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1007\/s00247-015-3304-1","article-title":"Imaging of the elbow in children with wrist fracture: an unnecessary source of radiation and use of resources?","volume":"45","year":"2015","journal-title":"Pediatr Radiol"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/BPB.0b013e328341df92","article-title":"Ipsilateral proximal and distal forearm fracture\/fracture dislocation in children","volume":"20","year":"2011","journal-title":"J Pediatr Orthop B"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.pcl.2005.10.003","article-title":"Pediatric upper extremity injuries","volume":"53","year":"2006","journal-title":"Pediatr Clin North Am"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/BPO.0000000000000213","article-title":"Pediatric Monteggia fractures: a multicenter examination of treatment strategy and early clinical and radiographic results","volume":"35","year":"2015","journal-title":"J Pediatr Orthop"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/01241398-199905000-00011","article-title":"A 10-year study of the changes in the pattern and treatment of 6,493 fractures","volume":"19","year":"1999","journal-title":"J Pediatr Orthop"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"a1518","DOI":"10.1136\/bmj.a1518","article-title":"Patterns of skeletal fractures in child abuse: systematic review","volume":"337","year":"2008","journal-title":"BMJ"},{"key":"bib12-20250504","first-page":"13","article-title":"Major trauma and the injury severity score\u2014where should we set the bar?","volume":"51","year":"2007","journal-title":"Annu Proc Assoc Adv Automot Med"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1053\/jhsu.2001.26322","article-title":"The frequency and epidemiology of hand and forearm fractures in the United States","volume":"26","year":"2001","journal-title":"J Hand Surg Am"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s11832-014-0577-0","article-title":"Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays","volume":"8","year":"2014","journal-title":"J Child Orthop"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0020-1383(01)00198-X","article-title":"Current management of torus fractures of the distal radius","volume":"33","year":"2002","journal-title":"Injury"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:08:25Z","timestamp":1746382105000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002176","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}