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Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study

Baker, Ruth; Orton, Elizabeth; Tata, Laila J.; Kendrick, Denise


Ruth Baker

Laila J. Tata

Professor of Primary Care Research


Aim: To investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions.
Methods: Population-based matched nested case–control study using The Health Improvement Network, a UK primary care research database, 1988–2004. Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23 661controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression.
Results: Fractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13–24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0–12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history.
Conclusions: Risk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions.


Baker, R., Orton, E., Tata, L. J., & Kendrick, D. (2015). Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study. Archives of Disease in Childhood, 100(5),

Journal Article Type Article
Publication Date May 1, 2015
Deposit Date Oct 26, 2015
Publicly Available Date Oct 26, 2015
Journal Archives of Disease in Childhood
Print ISSN 0003-9888
Electronic ISSN 1468-2044
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 100
Issue 5
Keywords Risk Factors, Long-Bone Fractures, Children
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Baker Arch Dis Child 2015.pdf (402 Kb)

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