Epidemiological trends and features of pediatric hand and elbow fractures in emergency department visits in Korea: a nationwide population-based study

Purpose: We aimed to investigate the recent epidemiological characteristics of pediatric hand and elbow fractures in patients visiting emergency departments (EDs) in Korea.Methods: Pediatric patients under 19 years of age who visited EDs nationwide for hand or elbow fractures in 2022 were included using data from the National Emergency Department Information System. Demographic and clinical variables—including sex, age, cause of injury, fracture site, season, day of the week, and time of day—were analyzed. Incidence patterns were examined across these variables.Results: Male patients accounted for 70.9% of cases, with a boy-to-girl ratio of 2.4, which increased with age but was nearly equal among children under 5 years old. Distinct patterns were observed for each variable. The highest incidence of fractures occurred in males aged 11 to 14 years and females aged 5 to 10 years. Incidence peaked in early summer and autumn, with emergency visits most frequent on weekends and between 4:00 and 8:00 PM. Distal humerus and proximal forearm fractures were mostly caused by falls, forearm shaft fractures were commonly associated with bicycle accidents, and distal forearm fractures were most frequently related to slipping. Phalangeal fractures predominantly resulted from being struck by others.Conclusion: Pediatric hand and elbow fractures exhibit distinct patterns influenced by various demographic and environmental factors. These differences appear to arise from both biological and behavioral factors associated with age and gender. The findings may help guide the development of targeted prevention strategies for pediatric populations.