Decreasing Incidence and Changing Pattern of Childhood Fractures: A Population-Based Study

Fractures are common in children, and some studies suggest an increasing Incidence Data on population-based long-term trends are scarce In order to establish fracture incidence and epidemiologic patterns, we carried out a population-based study in Helsinki, Finland All fractures in children aged 0 to 15 years were recorded from public health care institutions during a 12-month period in 2005 Details regarding patient demographics, fracture site, and trauma mechanism were collected All fractures were confirmed from radiographs Similar data from 1967, 1978, and 1983 were used for comparison In 2005, altogether 1396 fractures were recorded, 63% in boys The overall fracture incidence was 163 per 10,000 Causative injuries consisted of mainly falls when running or walking or from heights less than 1 5 m Fracture incidence peaked at 10 years in girls and 14 years in boys An increase in fracture incidence was seen from 1967 to 1983 (24%, p < 0001), but a significant decrease (18%, p < 0001) was seen from 1983 to 2005 This reduction was largest in children between the ages of 10 and 13 years Despite the overall decrease and marked decrease in hand (-39%, p < 0001) and foot (-48%, p < 0001) fractures, the incidence of forearm and upper arm fractures increased significantly by 31% (p < 0001) and 39% (p = 021), respectively Based on these findings, the overall incidence of childhood fractures has decreased significantly during the last two decades Concurrently, the incidence of forearm and upper arm fractures has increased by one-third The reasons for these epidemiologic changes remain to be elucidated in future studies (C) 2010 American Society for Bone and Mineral Research