Table 3 Summary of study characteristics

Dalton, 1990 [4]

3 Michigan Hospitals, USA

1979-1983

<36

Femur fracture all types

Additional injuries^b

L4 / 3a

138

Thomas, 1991 [20]

Yale-New Haven Hospital, USA

1997-1984

<36

Femur fracture all types

Pathologic fracture

L5 / 3b

25^c

Kowal-Vern, 1992 [21]

Loyola University Medical Center, USA

1984-1989

<36

Femur fracture all types

None

L4 / 3a

14^c

Blakemore, 1996 [22]

C.S. Mott Children’s Hospital, USA

1979-1993

12-71

Isolated femur diaphyseal fracture

Pathologic fractures, MVC related fractures, additional injuries^b

L4 / 1

42

Hinton, 1999 [23]

Hospital Discharge Database of the Maryland Health Services Cost Review Commission, USA

1995-1996

<24

Femur diaphyseal fractures

Non-acute fracture, multiple admissions

L3 / 4

73^c

Rex, 2000 [24]

Manchester Children’s Hospitals, UK

1992-1996

<60

Femur fracture all types, definite abuse or accident

Unclear etiology, non-acute fractures

L5 / 3a

33^c

Scherl, 2000 [25]

The University of Chicago Children’s Hospital & King’s County Hospital, USA

1986-1996

<72

Closed diaphyseal femur fracture

Non-diaphyseal fractures, open fracture, pathologic fracture

L3 / 2

207

Schwend, 2000 [26]

Children’s Hospital of Buffalo, New York, USA

1993-1997

<48

Diaphyseal femur fracture

Pathologic fracture, additional injuries^b

L4 / 1,3b

139

Banaszkiewicz, 2002 [36]

Royal Aberdeen Children’s Hospital, UK

1995-1999

<12

Femur fracture all types

None

L4 / 3b

12^c

Jeerathanyasakun, 2003 [33]

Queen Sirikit National Institute of Child Health, Thailand

1996-2001

<60

Diaphyseal femur fracture

Non-diaphyseal fracture, distal greenstick fracture, pathologic fracture

L4 / 3b

39

Coffey, 2005 [27]

Children’s Hospital, Columbus, OH, USA

1998-2002

< 18

Femur fracture all types

None

L4 / 5

41^c

Pierce, 2005 [31]

Children’s Hospital of Pittsburgh, PA, USA

1999-2002

≤36

Femur fracture all types, reported history of stair fall

Reported history other than stair fall

L2 / 3a

29

Rewers, 2005 [35]

Colorado Trauma Registry, USA

1998-2001

<36

Femur fracture all types

Pathologic fracture, non-Colorado resident, repeat admission for complication

L3 / 4

332 ^c

Loder, 2006 [19]

National (Kids’ Inpatient Database, USA)

2000

< 24

Femur fracture all types

None

L1 /4

1,076^c

Arkader, 2007 [28]

Two Level I pediatric centers, USA

1995-2005

≤ 12

Complete distal metaphyseal femur fracture

Incomplete metaphyseal and epiphyseal fractures

L3 / 4, 5

20

Trokel, 2006 [5]

National (Kids’ Inpatient Database, USA)

1997

<12

Femur fracture all types, admitted through ED

MVC, gunshot, or stabbing related fracture; no external cause of injury code

L3 / 4

426^c

Leventhal, 2007 [29]

Yale-New Haven Children’s Hospital, CT, USA

1979-1983 1991–1994 1999-2002

<36

Femur fracture all types

Pathologic fracture

L4 / 3b

81^c

Hui, 2008 [30]

Alberta Children’s Hospital, Canada

1994-2005

<36

Femur fracture all types

Pathologic fracture

L4 / 3b

127

Leventhal, 2008 [10]

National (Kids’ Inpatient Database, USA)

2003

<36

Femur fracture all types

None

L1 / 4

4,026^c

Baldwin, 2011 [2]

The Children’s Hospital of Philadelphia, PA, USA

1998+

<48

Femur fracture all types

Pathologic fracture, cause of fracture not clearly determined

L5 / 4

209

Heideken, 2011 [34]

Swedish National Hospital Discharge Registry, Sweden

1987-2005

<12

Diaphyseal femur fracture

Non-diaphyseal fracture, pathologic or birth fracture, multiple femur fractures

L3 /4

313^c

Shrader, 2011 [32]

Phoenix Children’s Hospital, AZ, USA

2003-2008

<60

Diaphyseal femur fracture

Pathologic fractures, non-diaphyseal fractures

L3 / 4

137

Wood, 2012 [6]

Pediatric Health Information System Database (40 pediatric hospitals), USA

1999-2009

<12

Femur fracture all types

MVC, birth, or neoplasm related fractures

L3 / 4

2,975^c

Capra, 2013 [18]

The Hospital for Sick Children, Toronto, Canada

1995-2004

12-59

Femur fracture all types

Non ambulatory children, pathological fractures

L3 /1

203