Epidemiology of appendicular skeletal fractures: a cross-sectional analysis of data from the Nottingham Fracture Liaison Service.

BACKGROUND

The aim of this study is to describe the population-based age and gender appendicular skeletal fracture incidence in Nottinghamshire, a medium-size health county in the UK.

METHOD

Data were analysed from the Nottingham Fracture Liaison Service Database over 4 years (2008-2011) on patients over 50 years of age. ICD-9 codes were used to classify fracture sites. Population figures from the Office of National Statistics were used to calculate fracture incidence rates per 10,000 population. Those aged 75 years and older were used to define the elderly population.

RESULTS

A total of 7,767 patients with 7,806 fractures presented over this time period. The overall incidence in males was 24/10,000 and in females 73/10,000. The incidence of fracture increased with age in females (R (2) = 0.90) compared to males (R (2) = 0.06). The over 75 population is more likely to fracture their wrist (OR 1.36, 95% CI 1.24-1.50, p < 0.01), humerus (OR 1.87, 95% CI 1.65-2.12, p < 0.01) and clavicle (OR 1.34, 95% CI 1.07-1.69, p = 0.011) compared to other fractures. There was linearity with radius/ulna and humerus fractures with age (R (2) = 0.92, R (2) = 0.97, respectively).

CONCLUSION

The incidence of appendicular skeletal fractures is high especially in the elderly female population with fractures of the upper limb more common. With an ageing population these numbers are projected to increase and therefore effective strategies to prevent falls and osteoporosis are clearly necessary.