Secular trends in incidence and seasonal variation of distal radius fracture among children: A nationwide study based on the Swedish National Patient Register 2002-2016.

Abstract

Although distal radius fracture (DRF) is the most common fracture type in children, research on its seasonality across different age groups is limited. We investigated secular trends in incidence and seasonal variation of pediatric DRF based on Swedish nationwide population database. In this observational study, data for all children aged <18years in Sweden with DRF defined by ICD-codes were analyzed for each month and each year during 2002-2016 using the Swedish National Patient Register. The general population counts for each age and sex-category were acquired to evaluate population at risk for each period. We calculated the age standardized and sex specific annual incidence rates, seasonal incidence rates, and monthly incidence rates and analyzed the seasonal variation in the mechanisms of injury. A total of 155,891 DRF cases were identified. The age standardized and sex specific incidence rate was 531 (95%CI 528-533) per 100,000 patient years at risk. Fracture risk was highest during summer and lowest in the winter. The highest seasonal variation was observed among boys 2-<5years. The crude incidence rate and the age-standardized incidence rates in winter significantly decreased between 2002 and 2016 (annual percentage change, -2%). We found significant seasonal variation in DRF among all age groups in Swedish children. The findings can help in developing strategies to prevent fractures as well as in allocating medical and social resources.