Upper Limb Injuries in Children Presenting to a Tertiary Care Center in Rural Nepal

Abstract

Background: Upper limb injuries are one of the common pediatric conditions presenting to our orthopedic department. The aim of this study is to identify the cause pattern and demographic characteristics of upper limb injuries in children so that various preventive strategies can be encouraged to reduce their morbidity.
Methods: A descriptive cross-sectional study was conducted at Karnali Academy of Health Sciences after ethical permission from October 2022 to March 2024. An enumerative sampling technique was used. Age, sex, address, side, upper limb anatomical location, time of hospital presentation, mode of injury, seasonal trend, prehospital management and other associated injuries were noted in individual structured proforma. All the data were entered in MS EXCEL and analyzed using version 16 of the Statistical Package for Social Sciences.
Results: A total of 437 children were involved in this study. Distal humerus fracture was seen in 149 (28%) patients, whereas distal radius fracture was observed in 131 (24.4 %) patients. Injury was common in children 6-9 years of age (27.5%). There were 313 (71.6%) boys and 124 (28.3%) girls. Delay of > 72 hours in presentation to hospital was noted in 88 (20%) patients. Out of 437 children, 76 (17%) received prehospital management.
Conclusions: Upper limb injuries were prevalent around elbow and wrist joint. Injuries were common in boys and predominant in 6-9 years of age. Fall from cliff, tree, rooftop and ladder were the major mode of injury in our rural context.
Keywords: Children; injuries; rural; upper limb.