Incidence of Childhood Distal Forearm Fractures Over 30 Years

Abstract

REVIOUS STUDIES HAVE SHOWNthat the incidence of distal forearm fractures in children peaks during early adolescence around the time of the pubertal growth spurt. [1][2][3] This observation has been explained on the basis of a transient increase in cortical porosity that results from enhanced bone turnover in response to greater calcium demand at the time of maximal longitudinal bone growth. 4 Such a process might be especially problematic given the thin cortex of the metaphyseal region of the distal radius, 5 and growth-related structural changes in the metaphysis further compromise bone strength in the distal forearm. 6 Adolescence is also characterized by the increase in physical activity necessary to maximize skeletal mass. 7-9 Thus, Parfitt 4 has suggested that forearm fractures in adolescence are "an inescapable consequence of an appropriate level of physical activity, and [are] the price that has to be paid in order to maximize bone accumulation during growth and minimize fracture risk in old age." To some extent, then, forearm fractures in adolescence may represent a transient imbalance between physical activity and acquisition of bone mass during puberty. This relationship may have changed over the years, due either to changing patterns of physical activity or to alterations in acquisition of bone mass, related perhaps to changing dietary habits.The incidence of distal forearm fractures among Rochester, Minn, residents younger than 35 years in 1969-1971 was reported previously. 10 The purpose of the present investigation was to estimate the incidence of such fractures among comparable Rochester residents 10, 20, and 30 years later in 1979-

Decreasing incidence and changing pattern of childhood fractures: A population-based study

“…(6,7,9,14,(28)(29)(30) None of the anatomic sites alone was responsible for the decrease in overall incidence but was most pronounced in hand and foot fractures. The surprising increase in the incidence of forearm and upper arm fractures is parallel to reports from the United States and Japan (11,12) and in line with a recent Finnish registry-based nationwide study on operatively treated fractures between 1997 and 2006. (19) A similar increase in forearm fractures also was seen in Sweden from 1975 to 1994 in girls (15) but not in boys.…”

“…(1,(5)(6)(7) The pattern of fractures varies between countries and even regions within a country, depending on local climate, culture, and leisure-time activities. (7)(8)(9)(10) Some studies have shown an increasing incidence of pediatric fractures at specific sites, (11,12) but population-based data on overall pattern and epidemiologic trends of childhood fractures are scarce. (13) In Sweden, the incidence of childhood fractures, especially of those caused by low-energy trauma, almost doubled from the 1950s to 1970s, (1,14) reaching an incidence of 212 fractures per 10,000 population.…”

Alimentary Factors of Bone Tissue Development in Children and Adolescents. Preventive Measures Against Potential Disorders

“…В скобках -% детей с недостаточным потреблением кальция. увеличение числа зарегистриро-ванных случаев переломов костей предплечья в когорте лиц младше 35 лет приходилось на возраст 11-14 лет у мальчиков (у 11-15% в год) и 8-11 лет у девочек (у 8-12% в год) [18]. По результатам изучения анало-гичной проблемы J. Konstantynowicz и соавт., именно это обстоятельство стало определяющим для четырех-кратного увеличение риска перелома костей у девочек, но не у мальчиков [19].…”

“…В связи с этим важно отметить, что в США за период с 1977-1978 по 1994-1996 гг. произошло снижение потребления молока девочками старшего школьного возраста почти на 2/3 на фоне поч-ти двукратного увеличения потребления неалкогольных напитков [18].…”

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

“…Despite the growing body of published normative data utilizing DXA in children, there are no evidence-based guidelines for the definition of osteoporosis in children. Fractures occur commonly in otherwise healthy children, with a peak incidence during early adolescence around the time of the pubertal growth spurt [34]. Several studies have compared the DXA BMD of normal children and adolescents with forearm fractures to that of age-matched controls without fractures.…”