Abstract
BACKGROUND: The objective of this study was to analyze the characteristics and trends of consumer product-related fractures among children < 18 years old treated in United States (US) emergency departments (EDs). METHODS: National Electronic Injury Surveillance System data for 1990-2023 were analyzed and national fracture estimates were calculated. US Census Bureau data were used to calculate annual fracture rates. RESULTS: An estimated 24,071,446 children < 18 years old were treated for nonfatal consumer product-related fractures in US EDs during 1990-2023, and 7.8% were admitted to the hospital. The average annual rate of pediatric fractures was 983.8 per 100,000 US children < 18 years old, and overall, the rate decreased by 26.8% during the study. Males accounted for 65.0% of fractures and were more likely than females to be admitted (OR: 1.094, 95% CI: 1.091-1.098). However, the difference in the rate of fractures between males and females narrowed during the study. The number of fractures peaked at age 11 years among females compared with 13 years among males. Fractures occurred most frequently in the home (38.7%), followed by a place of sports or recreation (32.7%) and school (19.5%). The most common injury mechanism was fell off/rolled off (36.4%), followed by play and/or sport (25.0%). Most (71.4%) fractures involved the upper extremity. Children < 6 years old had the highest hospital admission rate from 2009 to 2023 and were twice as likely to be admitted (OR: 1.986, 95% CI: 1.979-1.992) than older children during the study. Most (70.6%) fractures were associated with sports and recreation activities and equipment. Fractures involving home furnishings, fixtures, and accessories (OR: 1.221, 95% CI: 1.215-1.227) or the injury mechanism of fell off/rolled off (OR: 1.435, 95% CI: 1.430-1.439) were more likely to be associated with hospital admission than fractures associated with other products and activities or injury mechanisms, respectively. CONCLUSIONS: To our knowledge, this is the first study to investigate secular trends of consumer product-related fractures among US children, locations where fractures occurred, injury mechanisms, and associated consumer products and activities. The characteristics and trends of pediatric fractures identified in this study can help inform future research and prevention of these common injuries.