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J Child Orthop. 2018 Dec 1;12(6):614-621. doi: 10.1302/1863-2548.12.180114.

Trends in the seasonal variation of paediatric fractures.

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Department of Orthopaedic Surgery, Meir Medical Center, Kfar Saba, Israel, affiliated with Tel Aviv University, Tel Aviv, Israel.
Department of Orthopaedic Surgery, Schneider's Children's Hospital, Rabin Medical Center, Israel, affiliated with Tel Aviv University, Tel Aviv, Israel.



The incidence of paediatric fractures is known to peak during the summer as a consequence of unsupervised physical activity. A more sedentary lifestyle is a potential cause for changes in paediatric seasonal fracture frequency and severity. The aim of this study was to evaluate the current seasonal variations of paediatric fractures in order to determine resource allocation in hospitals, community clinics and prevention programs.


A single institutional review of historical data of all patients aged 0 to 16 years that were diagnosed with fractures between April 2014 and July 2017 in the emergency department of a level 3 orthopaedic trauma centre was conducted. In all, 3484 fractures were reviewed, of which 2991 were included. We stratified fractures according to patients' variants and the hour, day and month with respect to holidays, weekends and weather.


While the fracture rate on school days was 6.62 per day, the fracture rate during the summer vacation was 4.45 (p < 0.01). Hot weather was correlated with low fracture rates. The peak hours of admission were 12:00 to 13:00 and 18:00 to 22:00, with more moderate differences during non-school periods.


The local seasonal variation of paediatric fractures has a bimodal distribution, with similar nadirs during both summer and winter. These rates might reflect a shift to a more sedentary lifestyle during the summer vacation. The presented data can assist in improving the value of injury prevention measures and medical resources allocation.

Level of evidence:



children; epidemiology; paediatric fractures; seasonal variation

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