ORIGINAL RESEARCH article
Front. Public Health
Sec. Injury Prevention and Control
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1709382
This article is part of the Research TopicNavigating Child Injury Prevention and Safety Promotion: Strategies, Evidence, and Sustainable TransformationsView all 3 articles
Epidemiological Features and Injury Patterns of Multiple Fractures in Children: A Cross-Sectional Study
Provisionally accepted
- Children's Hospital of Nanjing Medical University, Nanjing, China
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Objective: This study aims to evaluate the epidemiological features of multiple pediatric fractures and identify specific injury patterns. Methods: This cross-sectional study retrospectively analyzed medical records for children with multiple fractures who presented to Children's Hospital of Nanjing Medical University between 2016 and 2024. Fractures were categorized into six anatomical regions: Craniofacial, Trunk/Pelvis, Upper Limb, Lower Limb, Hand, and Foot. Patients were divided into single-region and multi-region groups based on the number of affected regions. Hierarchical clustering on principal components (HCPC) was applied to explore potential injury patterns. Results: Among the 1950 children with multiple fractures, 65.0% were boys, with a median age of 8.7 years (4.8-12.3 years). The primary mechanisms of injury included ground-level falls (36.3%), traffic accidents (13.8%), and play/sports activities (10.8%). Single-region fractures accounted for 77.2%, while multi-region fractures accounted for 22.8%. There were statistically significant differences in age and injury mechanism distributions between the two groups (P<0.001). In the single-region group, children aged 6-11 years predominated, with ground-level falls being the most common cause (44.4%) primarily resulting in upper limb fractures (74.4%). The multi-region group had a higher representation of adolescents aged 12-17 years, with traffic accidents as the primary cause and injuries mainly involving the lower limbs (63.5%), trunk (56.8%), and upper limbs (50.5%). HCPC identified five distinct injury patterns: Lower Limb-Foot, Trunk/Pelvis-High Fall, Upper Limb-Hand, Craniofacial-Traffic Accident, and Upper Limb-Trunk/Pelvis patterns. Conclusion: Most pediatric multiple fractures involve a single anatomical region; however, the burden of cross-regional fractures should not be overlooked. Identifying potential injury patterns is crucial for developing targeted preventive strategies.
Keywords: Multiple fracture, Children, injury pattern, Hierarchical Classification onPrincipal Components (HCPC), China
Received: 20 Sep 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Gu, Guo, Sun, Wang and Ni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lei Ni, njetyynl@163.com
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