Update of the Most Frequent Pediatric Orthopedic Injuries From a National Inpatient Population

Background: One in four children in the U.S. sustains an accidental injury that requires medical care each year resulting in large personal and societal costs. Objectives: (1) To identify the most frequent pediatric orthopedic injuries requiring hospitalization in the U.S. and (2) to estimate the hospital charges and mortality rates associated with these injuries. Methods: Data were extracted from the 2006 Kids' Inpatient Database (KID). The ten most frequent pediatric orthopedic hospitalized injuries were identified from among ICD-9-CM codes 800.0-999.9. Discharges were weighted to produce nationally representative estimates, characterized according to gender, ethnicity, average length of stay and location, and compared to 1997 KID data. Results: Of the 86,925 traumatic orthopedic injury hospital discharges, the 10 most frequent injuries comprised 72,754 cases (83.7% of total). Total hospital charges were estimated to be $1.39 billion. Average admission age was 12 years, average length of stay was 3.2 days, average total hospital charges were $27,292, and the mortality rate was 0.08%. Femur and humerus fractures were the leading pediatric orthopedic injuries. Knee/leg sprains and strains were the only injuries among the top ten that were not bone fractures. Rates of femur, humerus, radius/ulna, vertebral, and hand/finger fractures varied significantly by gender, ethnicity, and geographic region. Compared to 1997 data, injury rankings, incidence rates, and length of stay held fairly stable; however, estimated total charges for injuries doubled over the decade. Conclusion: Identifying modifiable factors associated with the increasing costs and developing effective injury prevention programs should be the foci of future studies.