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[Prognostic factors of secondary complications in pediatric traumatology: a prospective study of 700 patients].

BACKGROUND
The objective of the study was to estimate prevalence of therapeutic complications in a department of orthopedics pediatric surgery, and to determine predictors of minor and serious complications.


METHODS
Between November 1996 and 1997, children less than or equal to 17 years of age, admitted for bone fracture (head and face excepted) were selected in a prospective study. In all, 700 children were treated until bone consolidation. Individual, socio-economic, anatomical, environmental and therapeutic factors were progressively registered. All complications were noted.


RESULTS
The mean age of the children was 9.2 years; 25 patients could not be traced. Prevalence rate of therapeutic complications was 10.3%. In multivariate analysis using logistic regression, six factors increased the risk of adverse event: kind of fracture (diaphysial), comminuted aspect, compounded fracture and bone displacement, season (spring and autumn), and use of medical transport between accident place and hospital. The same factors, season and compounded fracture excepted, were predictors of serious complications.


CONCLUSION
The results show that therapeutic complications depend on anatomical and environmental factors above all, and that medical procedure is not a prognosis factor. So if prevention of fractures is possible before injury, a better knowledge of initial risk can improve prevention of complications.