Seasonal Trends in Operative Pediatric Supracondylar Humerus and Femoral Shaft Fractures at a Pediatric Level 1 Trauma Center

Abstract

Tyler Tetreault, Amrita Mahajan, Christina E Howell, Lori J Silveira and Julia S Sanders

Background: Supracondylar humerus (SCHF) and femoral shaft (FSF) fractures are two common injuries at pediatric trauma centers. While anecdotally we see an increase in injuries with warmer weather, the purpose of this study was to objectively describe the seasonal variation in these operative fractures, and their relative burden on hospital census.

Methods: We performed an IRB-approved, retrospective review of 1626 SCHF and 601 FSF treated operatively from 2013-2018 at a single level 1 pediatric trauma center. Dates of injury were categorized with hospital census information, and temperature and precipitation data were obtained through the National Weather Service.

Results: For every 10º F increase in temperature, there was a 5% increased likelihood of FSF (p=0.048) and a 26% increased likelihood of SCHF (p=<0.0001). FSF were less likely to occur on weekdays than weekends (OR 0.59, p<0.0001) and less likely to occur on days with precipitation (OR 0.41, p= 0.03). SCHF demonstrated no significant weekly or precipitation-related trends. SCHF represent a significantly larger burden on orthopedic volume during summer months. The ratio of operative FSF relative to the total orthopedic volume per month did not correlate with season.

Conclusions: As often anecdotally reported, SCHF volumes mirror temperature variations annually. FSF appear to have more complex trends, with increased incidence on weekends regardless of season. Geographic variation in weather contributes strongly to pediatric trauma volume, and the ability to forecast a hospital system’s operative fracture volume allows for responsible resource allocation during key periods. Level of Evidence: Retrospective case series, Level IV

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