Kannus Pekka, Niemi Seppo, Parkkari Jari, Sievänen Harri
Injury and Osteoporosis Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland.
Department of Orthopedics and Trauma Surgery, Medical School, Tampere University Hospital, University of Tampere, Tampere, Finland.
Arch Orthop Trauma Surg. 2016 Sep;136(9):1243-1246. doi: 10.1007/s00402-016-2524-7. Epub 2016 Jul 21.
Fall-induced fractures of older adults are a major public health concern. However, nationwide information on recent fracture trends is sparse.
We determined the trend in the number and incidence (per 100,000 persons) of fall-induced ankle fractures among older adults in Finland by taking into account all persons 60 years of age or older who were admitted to Finnish hospitals for primary treatment of such fracture in 1970-2014.
The number of fall-induced ankle fractures among 60-year-old or older Finnish persons increased steadily and sharply between 1970 (369 fractures) and 1997 (1668 fractures), but since then, the increase has slowed down (1835 fractures in 2014). The raw incidence of ankle fracture, showing a clear rise from 57 fractures per 100,000 persons in 1970 to 169 fractures in 1997, declined steadily between 1997 and 2014 (to 126 fractures in 2014). Observations on the age-adjusted fracture incidence were similar. During 1970-1997, the age-adjusted incidence of fall-induced ankle fracture clearly rose in both women and men, but thereafter, the incidence declined; in women, from 199 in 1997 to 158 in 2014, and in men, from 123 in 1997 to 80 in 2014.
The sharp rise in the incidence of fall-induced ankle fracture in Finnish older adults from early 1970s until late 1990s has been followed by a declining fracture rate. Despite this welcome development, the rapid aging of our population is likely to increase the absolute number of these fractures in the near future, and therefore, large-scale fracture-preventing intervention studies are urgently needed.
老年人因跌倒导致的骨折是一个重大的公共卫生问题。然而，全国范围内关于近期骨折趋势的信息却很匮乏。
我们通过纳入1970年至2014年期间因此类骨折在芬兰医院接受初次治疗的所有60岁及以上的人群，确定了芬兰老年人因跌倒导致的踝关节骨折的数量和发病率（每10万人）的趋势。
1970年（369例骨折）至1997年（1668例骨折）期间，60岁及以上芬兰人因跌倒导致的踝关节骨折数量稳步且急剧增加，但自那时起，增长速度放缓（2014年为1835例骨折）。踝关节骨折的原始发病率从1970年的每10万人57例骨折明显上升至1997年的169例，在1997年至2014年期间稳步下降（2014年降至126例）。年龄调整后的骨折发病率观察结果相似。在1970年至1997年期间，因跌倒导致的踝关节骨折的年龄调整发病率在女性和男性中均明显上升，但此后发病率下降；女性从1997年的199例降至2014年的158例，男性从1997年的123例降至2014年的80例。
芬兰老年人因跌倒导致的踝关节骨折发病率从20世纪70年代初到90年代末急剧上升，随后骨折率下降。尽管有这一可喜的进展，但我们人口的快速老龄化可能会在不久的将来增加这些骨折的绝对数量，因此，迫切需要进行大规模的骨折预防干预研究。
