Childhood fractures in Bergen, Norway: identifying high-risk groups and activities.
ABSTRACT In 1998 the authors conducted a prospective registration of children younger than 16 presenting with a new traumatic fracture in the city of Bergen, Norway. In this epidemiologic study, the authors registered a total of 1.725 fractures in children; the fracture incidence was 245 per 10,000 children below the age of 16. One fifth needed reduction, and the distal radius was the most common fracture site (27%). Activities associated with fracture were mostly soccer and bicycling, but compared with the total number of injuries associated with each activity, we found a doubled risk of fractures during rollerblading/skating or snowboarding (60%) compared with playing soccer (38%) or bicycling (33%). Scaphoid fracture, an infrequent fracture in children, was seen in 9% of all fractures due to rollerblading/skating. There was a doubled risk of fracture in boys aged 13 to 15 compared with their female peers. To make fracture prevention more efficient, it should be targeted at this risk group and these high-risk activities. Protection of the wrist region might prevent the most common fractures.
Article: An association between socioeconomic, health and health behavioural indicators and fractures in young adult males.[show abstract] [hide abstract]
ABSTRACT: The aim of this survey study with 7,083 male respondents was to examine the association between socioeconomic, health and health behavioural risk indicators and fractures. In the multivariate regression model, fractures were associated strongest with frequency of drunkenness, regular sports training, frequent use of health care services and obesity. Little is known about the risk factors for fractures in young adults. Our aim was to identify the association between socioeconomic background, health and health behaviours and fractures. The survey sample comprised 7,378 conscript males (median age 19), of which 7,083 (96%) answered. The outcome was self-reported fracture. Associations between 20 background variables and fractures were analysed with logistic regression. Altogether 2,456 (34.7%) participants reported fracture(s) during their lifetime. The most common anatomical locations of fracture were the forearm, the hand and the ankle. The strongest risk indicators for fractures were frequent drunkenness (OR 1.7; 95% CI: 1.3-2.0), regular sports training (OR 1.6; 95% CI: 1.3-1.9), frequent use of health care services (OR 1.5; 95% CI: 1.3-1.8) and obesity (OR 1.5; 95% CI: 1.2-1.9). This is among the first studies to describe risk indicators for fractures in young adults. The strongest risk factors for fractures were associated with health damaging behaviour, high-intensity physical activity and use of health care services. Of socioeconomic background factors, only living in the capital city area was associated with fractures. Preventive measures should be targeted at the males frequently using health care services or actively participating in sports.Osteoporosis International 01/2008; 18(12):1609-15. · 4.58 Impact Factor
Article: Carpal scaphoid fracture in the skeletally immature: a single centre one-year prospective study.[show abstract] [hide abstract]
ABSTRACT: We report up-to-date one-year prospective data on the incidence of scaphoid fracture in skeletally immature patients managed in a Fracture Clinic of a Level I Trauma Centre in a University Hospital in the UK. All scaphoid fractures were immobilised until union was achieved. One hundred twenty one skeletally immature patients were referred for a suspected fracture of the scaphoid. Fourteen patients (11.5%) did have a scaphoid fracture, an incidence of 15 per 100,000 (0.55% of all paediatric injuries referred). Mean delay in being seen was 2.6 days, and mean follow-up time was 52.3 days. Only plain radiography was used to diagnose and follow up scaphoid fractures. Fractures of the scaphoid in skeletally immature individuals are uncommon, are usually undisplaced, occur more commonly in the distal portion of the bone, and carry a good prognosis.Acta orthopaedica Belgica 10/2009; 75(5):616-22. · 0.40 Impact Factor
[show abstract] [hide abstract]
ABSTRACT: Rate of fracture was examined according to age at first fracture in 313 New Zealand children (145 girls, 168 boys) under l3 years of age (95.4% of a consecutive series of children treated at one hospital for a recent confirmed fracture at any site). In their lifetimes they had experienced 468 separate fracture events, over half (54.7%) occurring in the 32.3% of children breaking bones on more than one occasion. Children experiencing a first fracture before 4 years of age had 36.7 (95%CI 30.7-44.1) fractures per l00 years of exposure: this was a significantly higher rate than that of children experiencing their first fracture later in life. Thus, using the <4.0 year age group as a reference, we found that rate ratios (adjusted for gender) for groups that had suffered the first fracture at later ages were: first fracture between 4.0 and 6.99 years, 0.77 (95%CI 0.58-1.03); first fracture between 7.0 and 9.99 years, 0.63 (95%CI 0.42-0.94); first fracture between 10.0 and 12.99 years, 0.48 (95% CI 0.32-0.72). Asthma was over-represented (31% seen, 25% expected), and a high proportion of the sample (32.9%) used corticosteroid medications; however, neither characteristic affected age at first fracture. In contrast, the large number (n= 42) of youngsters (13.4% of the sample) reporting adverse reactions to milk were younger at first fracture than children without reactions to milk (P<0.05). We conclude that children experiencing their first fracture at a young age have high rates of fracture and should be targeted for advice to improve their bone strength.Osteoporosis International 02/2006; 17(2):267-72. · 4.58 Impact Factor