Estimated Incidence of Pediatric Distal Radius Buckle Fractures in the United States

Abstract

Background: Distal radius buckle fracture care has been extensively studied, yet the incidence in the United States is unknown. This study aims to determine the incidence of pediatric buckle fractures using geospatial analysis. Methods: Pediatric distal radius buckle fractures (patients aged <18) from 2018 to 2022 were identified via a retrospective chart review from a single health care organization. The catchment area was defined as all of the home ZIP codes of verified buckle fracture patients. Corrections were made for buckle fractures treated at institutions with overlaying catchment areas. Adjusted incidence was then used to calculate annual buckle fractures nationally. Pediatric Orthopaedic Society of North America member rolls were used to identify and locate pediatric orthopaedic surgeons. It was assumed that each pediatric orthopaedic surgeon would treat up to 20 buckle fractures annually from a 25-mile radius of the primary office. Based on this, the percentage of buckle fractures nationally that are able to be treated by pediatric Orthopaedic surgeons was estimated. Results: A total of 594 distal radius buckle fractures over 5 years were confirmed in an estimated catchment area of 866,238 population. With adjustments for overlapping institutions, the estimated annual incidence was 17.3 per 100,000 people (95% CI [14.5, 20.1]). In the United States, there are an estimated 66,513 buckle fractures annually, with 1,182 pediatric orthopaedic surgeons potentially able to treat 26.5% of these cases. Conclusions: This investigation estimates the incidence of pediatric buckle fractures in the United States, allowing for estimates of expected volumes and implications for care. Based on the geographic distribution of pediatric orthopaedic surgeons and estimated incidence, it is impractical for buckle fracture care to be delivered exclusively by pediatric orthopaedic surgeons. Key Concepts: (1) The estimated annual incidence of distal radius buckle fracture is 17.3 per 100,000 people. (2) Pediatric orthopaedic surgeons are able to treat up to 26.5% of these cases. (3) Buckle fractures cannot be the exclusive domain of pediatric orthopaedic surgeons, as the number of pediatric Orthopaedic surgeons is too small for them to be the sole providers of care. Level of Evidence: III

Keywords

• Distal radius buckle fractures
• Fracture incidence
• Geospatial analysis
• Pediatric orthopaedic surgeons