Objective To identify high-risk factors for pediatric fractures in a hospital-based regional cohort. Methods We conducted a retrospective hospital-based cohort study including children ≤15 years treated for fractures at Yuncheng Central Hospital, Shanxi Province, between September 2021 and August 2024. Demographic (age, sex, BMI z-score, residence), injury-related (mechanism, time, season), and fracture characteristics were collected. Case identification and reporting were conducted in accordance with STROBE guidelines. Multivariable logistic regression models were prespecified to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs), alongside descriptive statistics. Results Among 1,664 cases, males accounted for a significantly higher proportion than females (male:female ratio 1.70:1; 95% CI: 1.54–1.88), with disparity increasing in adolescence. Adolescents (11–15 years) were more frequently hospitalized (31.8% vs. 14.0%, P 0.001). Summer showed the highest case burden, winter the lowest (outpatients 35.4% vs. 17.5%; inpatients 33.5% vs. 15.2%, P = 0.12). Daytime injuries predominated in inpatients (53.6% vs. 45.3%, P 0.01). Falls were the leading cause (68.2%), followed by traffic accidents (15.4%), bicycle-related injuries (8.6%), and other mechanisms (7.8%). Radius/ulna and clavicle fractures were commonly managed outpatient, while femoral and distal humeral fractures required hospitalization. Elevated BMI showed no significant association with fracture risk (6.5%). Conclusion Pediatric fractures in this regional cohort showed clear differences across sex, age, season, and time of injury. Younger children were mainly affected by fall-related injuries, whereas adolescents experienced more traffic- and activity-related trauma. These patterns suggest that prevention efforts should be tailored to developmental stages, such as improving home safety for preschoolers and reinforcing traffic and sports safety education for older children.
Li et al. (2026) studied this question.