Retrospective 2-year multicenter study of 488 elbow fractures in children under 15 across 11 hospitals in Okinawa, Japan. Characterizes fracture type distribution, operative rates by classification grade, age and sex patterns, seasonal variation, and leading injury mechanisms by age subgroup. Provides a Japanese regional comparison against Western epidemiologic benchmarks.
A child aged 6–10 presents after a fall while skateboarding with a swollen elbow — this cohort tells you that board sports are the top single mechanism in that age group, not bikes, and that the fracture is most likely supracondylar or lateral condyle.
When you see a medial epicondyle fracture, don't be reassured by 'minimal displacement.' Even Watson-Jones Grade I fractures were operated on 81.8% of the time in this series, because the key driver of instability is medial capsular ligament disruption. Not the fragment position itself. Assess for ulnar nerve function and valgus instability before committing to nonoperative management.
The Wadsworth and Gartland classifications are not just academic. They function as operative decision thresholds in practice. Gartland III is 100% operative. Wadsworth III is 100% operative. Grade II for both sits in the shared-decision zone (roughly 50–77%).
The near-flat seasonal distribution here is a useful reminder that epidemiology is population-specific. The 2.5–2.7× summer excess from Danish and Canadian data does not apply in subtropical or year-round warm climates.
Retrospective 2-year multicenter study of 488 elbow fractures in children under 15 across 11 hospitals in Okinawa, Japan. Characterizes fracture type distribution, operative rates by classification grade, age and sex patterns, seasonal variation, and leading injury mechanisms by age subgroup. Provides a Japanese regional comparison against Western epidemiologic benchmarks.
A child aged 6–10 presents after a fall while skateboarding with a swollen elbow — this cohort tells you that board sports are the top single mechanism in that age group, not bikes, and that the fracture is most likely supracondylar or lateral condyle.
When you see a medial epicondyle fracture, don't be reassured by 'minimal displacement.' Even Watson-Jones Grade I fractures were operated on 81.8% of the time in this series, because the key driver of instability is medial capsular ligament disruption. Not the fragment position itself. Assess for ulnar nerve function and valgus instability before committing to nonoperative management.
The Wadsworth and Gartland classifications are not just academic. They function as operative decision thresholds in practice. Gartland III is 100% operative. Wadsworth III is 100% operative. Grade II for both sits in the shared-decision zone (roughly 50–77%).
The near-flat seasonal distribution here is a useful reminder that epidemiology is population-specific. The 2.5–2.7× summer excess from Danish and Canadian data does not apply in subtropical or year-round warm climates.