Incidence of traumatic long-bone fractures requiring in-hospital management: A prospective age- and gender-specific analysis of 4890 fractures

Abstract

Background Musculoskeletal trauma represents a considerable global health burden; however, reliable population-based incidence data are lacking. Thus, we prospectively investigated the age- and sex-specific incidence patterns of long-bone fractures in a defined population. Methods A 4-year prospective study of all long-bone fractures in a defined Norwegian population was carried out. The demographic data, as well as data on fracture type and location and mode of treatment were collected using recognised classification (e.g., AO/OTA – Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association; Gustilo–Anderson (GA) for open fractures). Age- and sex-adjusted incidences were calculated using population statistics. Results During the study period, 4890 long-bone fractures were recorded. The overall incidence per 100,000 per year was 406 with a 95% confidence interval (95%CI) of 395–417. The age-adjusted incidence for those <16 years (339; 95%CI: 318–360) was lower than that for those ≥16 years (427; 95%CI: 414–440). The overall male incidence (337; 95%CI: 322–355) was lower than the female (476; 95%CI: 459–493), but the male:female ratio was 2:1 among those <50 years, and 1:3 in those ≥50 years. The upper limb fractures had an overall incidence of 159 (95%CI: 152–166), whereas the lower limb fracture incidence was 247 (95%CI: 238–256). Open fractures occurred in 3%, with an incidence of 13 (95%CI: 11–15). Paediatric fractures were more likely to be treated conservatively with only 8% requiring internal fixation, compared to 56% internal fixation in those ≥16 years of age. An increase in the use of angular stable plates occurred during the study period. Conclusion This prospectively collected study of long-bone fractures in a defined population recognises age- and gender-specific fracture patterns. Boys predominate in the younger age group for which treatment is basically conservative. In the senior population, women and operative treatment predominate.