The Epidemiology of Incident Fracture from Cradle to Senescence

Abstract

To reduce the burden of fracture, not only does bone fragility need to be addressed, but also injury prevention. Thus, fracture epidemiology irrespective of degree of trauma is informative. We aimed to determine age-and-sex-specific fracture incidence rates for the Barwon Statistical Division, Australia, 2006-2007. Using radiology reports, incident fractures were identified for 5342 males and 4512 females, with incidence of 210.4 (95 % CI 204.8, 216.2) and 160.0 (155.3, 164.7)/10,000/year, respectively. In females, spine (clinical vertebral), hip (proximal femoral) and distal forearm fractures demonstrated a pattern of stable incidence through early adult life, with an exponential increase beginning in postmenopausal years for fractures of the forearm followed by spine and hip. A similar pattern was observed for the pelvis, humerus, femur and patella. Distal forearm, humerus, other forearm and ankle fractures showed incidence peaks during childhood and adolescence. For males, age-related changes mimicked the female pattern for fractures of the spine, hip, ribs, pelvis and humerus. Incidence at these sites was generally lower for males, particularly among the elderly. A similar childhood-adolescent peak was seen for the distal forearm and humerus. For ankle fractures, there was an increase during childhood and adolescence but this extended into early adult life; in contrast to females, there were no further age-related increases. An adolescent-young adult peak incidence was observed for fractures of the face, clavicle, carpal bones, hand, fingers, foot and toe, without further age-related increases. Examining patterns of fracture provides the evidence base for monitoring temporal changes in fracture burden, and for identifying high-incidence groups to which fracture prevention strategies could be directed.

High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

“…In accordance, Burghardt et al reported an increased porosity in men and women [20] and Sundh et al reported an increased Ct.Po in elderly men who sustained a fracture independently of its location [15]. Those results match well with our data of the humerus showing the highest cortical bone loss around the age of 65 years, which is further supported by the highly increased incidence of humeral fractures after this age [1,3].…”

“…Fractures of the proximal humerus are the third most common fracture in the elderly [1][2][3]. Most of them occur during a low energy trauma and are related to osteoporotic changes of the bone [2,4].…”

Associations between asthma status and radiologically confirmed fracture in children: A data‐linkage study

“…We observed older age to be independently associated with fracture in both sexes; however, boys were more likely to fracture than girls, and the peak of fractures in boys occurred at an older age than girls. These observations have been previously reported by other smaller studies: Associations that appear biologically plausible. The sex‐specific associations between asthma and fracture may relate to sexual maturation, as girls enter puberty at a younger age than boys.…”

“…The GOSFracGrid captures all radiologically confirmed (all‐cause) fractures sustained by residents of the BSD, the methodology for which has previously been validated . For the current study, we extracted all fractures that occurred in children, resident in the BSD, during 2006–2007.…”

Dynamic contrast-enhanced ultrasound (CEUS) after open and minimally invasive locked plating of proximal humerus fractures

“…Proximal humerus fractures will become more common with increasing life expectancy of the population [1][2][3]. Whereas fractures without displacement can be treated conservatively with favorable outcome [4,5], the indication and ideal technique for a surgical intervention depend on several fracture and patient specific factors, e.g.…”