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The Epidemiology of Incident Fracture from Cradle to Senescence

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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.

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Acknowledgments

The study was supported by Australia National Health and Medical Research Council (NHMRC; project 628582), the Geelong Region Medical Research Foundation, the Arthritis Foundation of Australia and Amgen (Europe) GmBH but they played no part in the design or conduct of the study; collection, management, analysis, and interpretation of the data; or in preparation or review of the manuscript. SLB-O was supported by an Alfred Deakin Postdoctoral Fellowship, LJW by a NHMRC Career Development Fellowship (1064272) and NKH by an Australian Postgraduate Award.

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Authors and Affiliations

  1. School of Medicine, Deakin University, Geelong, VIC, Australia

    Julie A. Pasco, Stephen E. Lane, Sharon L. Brennan-Olsen, Kara L. Holloway, Elizabeth N. Timney, Gosia Bucki-Smith, Amelia G. Morse, Amelia G. Dobbins, Lana J. Williams, Natalie K. Hyde & Mark A. Kotowicz

  2. Department of Medicine, The University of Melbourne, St Albans, VIC, Australia

    Julie A. Pasco, Sharon L. Brennan-Olsen & Mark A. Kotowicz

  3. University Hospital Geelong, Barwon Health, Geelong, VIC, Australia

    Julie A. Pasco, Stephen E. Lane & Mark A. Kotowicz

  4. Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia

    Sharon L. Brennan-Olsen

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  1. Julie A. Pasco
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  2. Stephen E. Lane
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  3. Sharon L. Brennan-Olsen
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Correspondence to Julie A. Pasco.

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Conflicts of interest

Julie A. Pasco, Sharon L. Brennan-Olsen, Lana J. Williams and Mark A. Kotowicz have received funding from the NHMRC; Julie A. Pasco and Mark A. Kotowicz have received funding from the Geelong Region Medical Research Foundation, the Arthritis Foundation of Australia and Amgen (Europe) GmBH; Stephen E. Lane, Elizabeth N. Timney, Gosia Bucki-Smith, Amelia G. Morse, Amelia G. Dobbins and Natalie K. Hyde declare that there are no conflicts of interest. There are no disclosures.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Pasco, J.A., Lane, S.E., Brennan-Olsen, S.L. et al. The Epidemiology of Incident Fracture from Cradle to Senescence. Calcif Tissue Int 97, 568–576 (2015). https://doi.org/10.1007/s00223-015-0053-y

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