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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2018

01-12-2018 | Original Article

Appendicular fracture epidemiology of children and adolescents: a 10-year case review in Western Australia (2005 to 2015)

Authors: Mark Jenkins, Sophia Nimphius, Nicolas H. Hart, Paola Chivers, Timo Rantalainen, Kristina Rueter, Meredith L. Borland, Fleur McIntyre, Katherine Stannage, Aris Siafarikas

Published in: Archives of Osteoporosis | Issue 1/2018

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Abstract

Summary

Fracture incidence data of Australian children and adolescents have not been reported in the literature. A 10-year case review of fracture presentations in Western Australia is provided. Between 2005 and 2015, fracture incidence increased relative to population growth. This is concerning, and interventions are required to reverse this trend.

Purpose

Fracture incidence in 0–16-year-olds is high and varies between countries. Boys have a 1.5:1 ratio of fracture incidence compared to girls. There are no specific data for Australia. Western Australia is a state with unique geography and population distribution having only a single tertiary paediatric hospital (Princess Margaret Hospital, PMH, in Perth) managing the majority of children and adolescents with fractures in the Emergency Department (ED). The aims of this study were to characterise fracture presentations to PMH-ED and compare the incidence to population data.

Methods

A database audit of fracture presentations between 2005 and 2015 for fracture rates with a sub-analysis for gender, fracture site and age and a comparison to Perth Metropolitan and Western Australian population data was performed.

Results

Analysis included 31,340 presentations. Fracture incidence, adjusted for the annual population size, increased from 0.63% in 2005 to 0.85% in 2015 (p < 0.001). The month of May reported the highest fracture rate (p < 0.001) corresponding with the start of the winter sports season. Males had a 1.5 times higher fracture incidence than females (p < 0.001), with upper limb fractures three times more common than lower limb fractures (p < 0.001). Fracture incidence increased with age until the early teenage years (15 years for males; 12 years for females) when a decline occurred.

Conclusions

Increased fracture incidence in Western Australia between 2005 and 2015 identifies a concerning trend for bone health in children and adolescents. Further research is needed to identify potential lifestyle factors that impact fracture incidence translating into evidence-based strategies to reverse these trends and improve bone health.
Appendix
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Metadata
Title
Appendicular fracture epidemiology of children and adolescents: a 10-year case review in Western Australia (2005 to 2015)
Authors
Mark Jenkins
Sophia Nimphius
Nicolas H. Hart
Paola Chivers
Timo Rantalainen
Kristina Rueter
Meredith L. Borland
Fleur McIntyre
Katherine Stannage
Aris Siafarikas
Publication date
01-12-2018
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0478-9

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