{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:27:24Z","timestamp":1784035644736,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Open fractures in pediatric patients are uncommon but clinically relevant, often resulting from high-energy trauma or sports-related incidents. This study analyzes the demographic patterns, types of sports, injury mechanisms, treatment strategies, and outcomes in children and adolescents with sports-related open fractures. Methods: In this retrospective study, 74 pediatric patients with sports-related open fractures treated at a level 1 trauma center between 2002 and 2023 were documented. Parameters such as age, sex, fracture location, sport type, treatment modality, complications, and outcomes were evaluated. Results: The cohort included 74 patients, with a mean age of 13 \u00b1 3.6 years. Open fractures of the upper extremity were most common (seen in 34 patients). Moreover, 10 open craniofacial and 27 open nasal fractures represented 50.0% of injuries, mainly in male athletes involved in contact sports. Soccer was the leading injury-related sport (n = 14; 18.9%). Surgical treatment was required in 28 patients (37.8%), most frequently using elastic stable intramedullary nailing, Kirschner wire fixation in the upper extremities or nasal bone reduction. Antibiotics were administered in 46 patients (62.2%), with a mean documented duration of 2.7 \u00b1 3.1 days. An excellent outcome was documented in 95%. Conclusions: Sports-related open fractures in children primarily affect male adolescents in contact sports and involve the upper extremities and facial region. Conservative management is effective in stable, non-displaced and low-grade injuries. Surgical treatment is frequently indicated in open forearm fractures. The implementation of a structured trauma care protocol, incorporating early debridement, definitive treatment, and antibiotics, has been demonstrated to yield a safe and effective treatment outcome with a favorable prognosis for sports-related open fractures in children.<\/jats:p>","DOI":"10.3390\/jcm14186667","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:08:03Z","timestamp":1758542883000},"page":"6667","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Open Fractures on the Field: Two Decades of Pediatric Sports Injuries in a Level 1 Trauma Cohort"],"prefix":"10.3390","volume":"14","author":[{"given":"Britta","family":"Chocholka","sequence":"first","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Marie","family":"Bogensperger","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Yegorova","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Gro\u00df","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Jaindl","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University, Kavre 45200, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7752-6700","authenticated-orcid":false,"given":"Sanika","family":"Rapole","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, Pune 411005, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8698-8341","authenticated-orcid":false,"given":"Thomas Manfred","family":"Tiefenboeck","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Payr","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopedics and Trauma Surgery, Department of Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"ref_1","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","author":"Cheng","year":"1999","journal-title":"J. Pediatr. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1007\/s00068-024-02539-2","article-title":"Paediatric open fractures presenting to a level 1 trauma centre: A 10 year epidemiological study","volume":"50","author":"Wijesekera","year":"2024","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e29828","DOI":"10.1097\/MD.0000000000029828","article-title":"Incidence, characteristics, and treatments of traumatic open fractures in children and adolescents: A retrospective observational study","volume":"101","author":"Wang","year":"2022","journal-title":"Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.injury.2020.03.055","article-title":"Non-operative versus operative management of open fractures in the paediatric population: A systematic review and meta-analysis of the adverse outcomes","volume":"51","author":"Singh","year":"2020","journal-title":"Injury"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1302\/0301-620X.99B4.37855","article-title":"The management of open tibial fractures in children: A retrospective case series of eight years\u2019 experience of 61 cases at a paediatric specialist centre","volume":"99-B","author":"Nandra","year":"2017","journal-title":"Bone Jt. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2106\/00004623-200501000-00003","article-title":"The effect of surgical delay on acute infection following 554 open fractures in children","volume":"87","author":"Skaggs","year":"2005","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_7","first-page":"24","article-title":"The soft tissue management of children\u2019s open tibial fractures","volume":"44","author":"Stewart","year":"1999","journal-title":"R. Coll. Surg. Edinb."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e937","DOI":"10.1097\/BPO.0000000000002217","article-title":"Open Fractures in Pediatric Orthopaedics-Can Pathways Improve Care? A 1-Year Pre and Postimplementation Analysis","volume":"42","author":"Makarewich","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s11832-014-0567-2","article-title":"Delayed surgical debridement in pediatric open fractures: A systematic review and meta-analysis","volume":"8","author":"Ibrahim","year":"2014","journal-title":"J. Child. Orthop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13018-017-0657-1","article-title":"Upper extremity open fractures in hospitalized road traffic accident patients: Adult versus pediatric cases","volume":"12","author":"Rubin","year":"2017","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Aulisa, A.G., Marsiolo, M., Basiglini, L., Aletto, C., Giordano, M., and Falciglia, F. (2023). Management of Open Pediatric Fractures: Proposal of a New Multidisciplinary Algorithm. J. Clin. Med., 12.","DOI":"10.3390\/jcm12196378"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103771","DOI":"10.1016\/j.otsr.2023.103771","article-title":"Open fractures of the limbs in children and adolescents","volume":"110","author":"Fraisse","year":"2024","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.injury.2007.01.036","article-title":"The epidemiology of fractures in children","volume":"38","author":"Rennie","year":"2007","journal-title":"Injury"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1136\/bjsm.2006.033605","article-title":"Quantifying the risk of sports injury: A systematic review of activity-specific rates for children under 16 years of age","volume":"41","author":"Spinks","year":"2007","journal-title":"Br. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1097\/BPO.0000000000000099","article-title":"Trends in pediatric sports-related and recreation-related Injuries in the United States in the last decade","volume":"33","author":"Lykissas","year":"2013","journal-title":"J. Pediatr. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1177\/0363546514522393","article-title":"Pediatric sports injuries: A comparison of males versus females","volume":"42","author":"Stracciolini","year":"2014","journal-title":"Am. J. Sports Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"780","DOI":"10.4085\/1062-6050-49.3.41","article-title":"Child development and pediatric sport and recreational injuries by age","volume":"49","author":"Schwebel","year":"2014","journal-title":"J. Athl. Train."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1177\/0363546504269256","article-title":"Pediatric fractures during skateboarding, roller skating, and scooter riding","volume":"33","author":"Zalavras","year":"2005","journal-title":"Am. J. Sports Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3109\/17453671003628780","article-title":"Epidemiology of fractures in children and adolescents","volume":"81","author":"Hedstrom","year":"2010","journal-title":"Acta Orthop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1177\/1941738118798629","article-title":"Trends and Epidemiologic Factors Contributing to Soccer-Related Fractures That Presented to Emergency Departments in the United States","volume":"11","author":"Kuczinski","year":"2019","journal-title":"Sports Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"89","DOI":"10.7181\/acfs.2019.00017","article-title":"Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: Prospective study of 30 cases","volume":"20","author":"Jang","year":"2019","journal-title":"Arch. Craniofacial Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"319","DOI":"10.7181\/acfs.2021.00535","article-title":"Antibiotic use in nasal bone fracture: A single-center retrospective study","volume":"22","author":"Jung","year":"2021","journal-title":"Arch. Craniofacial Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e4886","DOI":"10.1097\/GOX.0000000000004886","article-title":"The Role of Antibiotics in Nasal Fractures after Closed Reduction","volume":"11","author":"Vishwanath","year":"2023","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1302\/1863-2548.11.170027","article-title":"The emerging trend of non-operative treatment in paediatric type I open forearm fractures","volume":"11","author":"Zhang","year":"2017","journal-title":"J. Child. Orthop."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kuhn, A.W., Troyer, S.C., and Martus, J.E. (2022). Pediatric Open Long-Bone Fracture and Subsequent Deep Infection Risk: The Importance of Early Hospital Care. Children, 9.","DOI":"10.3390\/children9081243"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1016\/j.injury.2019.10.074","article-title":"Prevention of infection in open fractures: Where are the pendulums now?","volume":"51","author":"Rupp","year":"2020","journal-title":"Injury"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/jpc.13471","article-title":"Paediatric horse-related trauma","volume":"53","author":"Theodore","year":"2017","journal-title":"J. Paediatr. Child. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1136\/bjsm.2007.035691","article-title":"Strategies to prevent injury in adolescent sport: A systematic review","volume":"41","author":"Abernethy","year":"2007","journal-title":"Br. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4103\/jisppd.jisppd_55_25","article-title":"Impact of mouthguards on the prevention of dentofacial injuries and sports performance among athletes: An umbrella review","volume":"43","author":"Agarwal","year":"2025","journal-title":"J. Indian Soc. Pedod. Prev. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1136\/bjsports-2023-106934","article-title":"Coaches of youth field sports as delivery agents of injury prevention programmes: How are we training the trainers? A scoping review","volume":"58","author":"Guilfoyle","year":"2024","journal-title":"Br. J. Sports Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6667\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:46:57Z","timestamp":1760035617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6667"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":30,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186667"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186667","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,22]]}}}