Pasco Julie A, Lane Stephen E, Brennan-Olsen Sharon L, Holloway Kara L, Timney Elizabeth N, Bucki-Smith Gosia, Morse Amelia G, Dobbins Amelia G, Williams Lana J, Hyde Natalie K, Kotowicz Mark A
School of Medicine, Deakin University, Geelong, VIC, Australia.
Department of Medicine, The University of Melbourne, St Albans, VIC, Australia.
Calcif Tissue Int. 2015 Dec;97(6):568-76. doi: 10.1007/s00223-015-0053-y. Epub 2015 Aug 29.
To reduce the burden of fracture, not only does bone fragility need to be addressed, but also injury prevention. Thus, fracture epidemiology irrespective of degree of trauma is informative. We aimed to determine age-and-sex-specific fracture incidence rates for the Barwon Statistical Division, Australia, 2006-2007. Using radiology reports, incident fractures were identified for 5342 males and 4512 females, with incidence of 210.4 (95 % CI 204.8, 216.2) and 160.0 (155.3, 164.7)/10,000/year, respectively. In females, spine (clinical vertebral), hip (proximal femoral) and distal forearm fractures demonstrated a pattern of stable incidence through early adult life, with an exponential increase beginning in postmenopausal years for fractures of the forearm followed by spine and hip. A similar pattern was observed for the pelvis, humerus, femur and patella. Distal forearm, humerus, other forearm and ankle fractures showed incidence peaks during childhood and adolescence. For males, age-related changes mimicked the female pattern for fractures of the spine, hip, ribs, pelvis and humerus. Incidence at these sites was generally lower for males, particularly among the elderly. A similar childhood-adolescent peak was seen for the distal forearm and humerus. For ankle fractures, there was an increase during childhood and adolescence but this extended into early adult life; in contrast to females, there were no further age-related increases. An adolescent-young adult peak incidence was observed for fractures of the face, clavicle, carpal bones, hand, fingers, foot and toe, without further age-related increases. Examining patterns of fracture provides the evidence base for monitoring temporal changes in fracture burden, and for identifying high-incidence groups to which fracture prevention strategies could be directed.
为了减轻骨折负担，不仅需要解决骨骼脆弱问题，还需要预防损伤。因此，无论创伤程度如何，骨折流行病学都具有参考价值。我们旨在确定2006 - 2007年澳大利亚巴旺统计区按年龄和性别划分的骨折发病率。利用放射学报告，确定了5342名男性和4512名女性发生了新发骨折，发病率分别为210.4（95%可信区间204.8, 216.2）和160.0（155.3, 164.7）/10000/年。在女性中，脊柱（临床椎体）、髋部（股骨近端）和前臂远端骨折在成年早期呈现稳定的发病率模式，绝经后前臂骨折开始呈指数增长，随后是脊柱和髋部骨折。骨盆、肱骨、股骨和髌骨也观察到类似模式。前臂远端、肱骨、其他前臂和踝关节骨折在儿童和青少年时期发病率达到峰值。对于男性，脊柱、髋部、肋骨、骨盆和肱骨骨折的年龄相关变化与女性模式相似。这些部位男性的发病率通常较低，尤其是在老年人中。前臂远端和肱骨在儿童和青少年时期也出现了类似的峰值。踝关节骨折在儿童和青少年时期有所增加，但这种增加一直持续到成年早期；与女性不同的是，没有进一步的年龄相关增加。面部、锁骨、腕骨、手、手指、足和趾骨折在青少年至青年成人期发病率达到峰值，没有进一步的年龄相关增加。研究骨折模式为监测骨折负担的时间变化以及确定可针对其采取骨折预防策略的高发病率群体提供了证据基础。
