Li Cun, Lin Qingyun
Department of Orthopaedics, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Microbiological Testing, Nanning Municipal Center for Disease Control and Prevention, Nanning, China.
Front Public Health. 2025 Jul 30;13:1627867. doi: 10.3389/fpubh.2025.1627867. eCollection 2025.
Lower extremity and pelvic fractures (LEPFs) are common and debilitating injuries with substantial global health and economic burden, yet comprehensive epidemiological data remain limited.
Based on Global Burden of Disease 2021, we analyzed incidence, years lived with disability (YLDs), and causes of LEPFs across 204 countries from 1990 to 2021, along with their temporal trends. The impact of age, sex and Socio-Demographic Index (SDI) was considered.
In 2021, 78.05 million new LEPF cases were reported globally, a 32% increase since 1990. Despite this, the age-standardized incidence rate (ASIR) declined annually by 0.68%, reaching 974.98 per 100,000 population in 2021. For anatomic subtypes, fractures of the patella, tibia or fibula, or ankle were most common (34.96 million), while hip fractures showed the largest increase for incident cases (126%) and a significant rising ASIR among males (0.21% annually). Conflict-affected countries in the Middle East and Africa saw the sharpest rises in LEPF burden. SDI correlated with elevated ASIR and age-standardized YLD rates (ASYR), particularly at SDI > 0.7. Falls were the leading cause, followed by road injuries. YLDs peaked among adults aged 45-60, with ASYR rising sharply in older populations. The disability burden increased during COVID-19 pandemic, exposing vulnerabilities in global fracture care systems.
LEPFs remain a significant public health challenge, driven by population aging, regional instability and osteoporosis. Hip fractures in males and LEPFs in conflict zones demand urgent attention. Strengthening fall prevention, implementing comprehensive osteoporosis management including sex-inclusive approaches, and targeted prevention strategies is essential to mitigating the global burden of LEPFs.
下肢及骨盆骨折（LEPFs）是常见且使人衰弱的损伤，给全球健康和经济带来巨大负担，但全面的流行病学数据仍然有限。
基于《2021年全球疾病负担》，我们分析了1990年至2021年期间204个国家的下肢及骨盆骨折发病率、伤残调整生命年（YLDs）及其病因，以及它们的时间趋势。同时考虑了年龄、性别和社会人口指数（SDI）的影响。
2021年，全球报告了7805万例新的下肢及骨盆骨折病例，自1990年以来增加了32%。尽管如此，年龄标准化发病率（ASIR）每年下降0.68%，2021年达到每10万人974.98例。就解剖亚型而言，髌骨、胫骨或腓骨或踝关节骨折最为常见（3496万例），而髋部骨折的发病病例增长幅度最大（126%），男性的年龄标准化发病率显著上升（每年0.21%）。中东和非洲受冲突影响的国家下肢及骨盆骨折负担上升最为明显。社会人口指数与年龄标准化发病率和年龄标准化伤残调整生命年率（ASYR）升高相关，特别是在社会人口指数>0.7时。跌倒为主要原因，其次是道路伤害。伤残调整生命年在45至60岁的成年人中达到峰值，老年人群的年龄标准化伤残调整生命年率急剧上升。在新冠疫情期间，残疾负担有所增加，暴露了全球骨折护理系统的脆弱性。
由于人口老龄化、地区不稳定和骨质疏松症，下肢及骨盆骨折仍然是一项重大的公共卫生挑战。男性髋部骨折和冲突地区的下肢及骨盆骨折需要紧急关注。加强预防跌倒、实施包括性别包容方法在内的全面骨质疏松症管理以及有针对性的预防策略对于减轻全球下肢及骨盆骨折负担至关重要。
