Decreasing incidence of fractures in children: An epidemiological analysis of 1,673 fractures in Malmö, Sweden, 1993–1994

Cj, Tiderius; Landin, Lars; Düppe, Henrik

doi:10.3109/17453679908997853

Cited by 104 publications

(135 citation statements)

References 9 publications

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“…This observation is in line with literature data because the peak incidence of fractures in girls occurs between 11 and 12 years of age and in boys between 13 and 14 years of age. (2,3,(23)(24)(25) Underlying this observation is a transient increase in bone fragility and cortical porosity leading to a deficit in bone mass relative to longitudinal growth. (26,27) In this regard, the peak height velocity in both boys and girls precedes the time of peak increase in bone mineral content by 1 year.…”

Section: Discussionmentioning

confidence: 99%

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Taes

Lapauw

Vanbillemont

et al. 2010

Journal of Bone and Mineral Research

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Low areal bone mass is a risk factor for fractures in men. Limited data are available on fractures and bone geometry in men, and the relation with sex steroids is incompletely understood. We investigated prevalent fractures in relation to peak bone mass, bone geometry, and sex steroids in healthy young men. Healthy male siblings (n ¼ 677) at the age of peak bone mass (25 to 45 years) were recruited in a cross-sectional population-based study. Trabecular and cortical bone parameters of the radius and cortical bone parameters of the tibia were assessed using peripheral quantitative computed tomography (pQCT). Areal bone mineral density (aBMD) was determined using dual-energy X-ray absorptiometry (DXA). Sex steroids were determined using immunoassays, and fracture prevalence was assessed using questionnaires. Fractures in young men were associated with a longer limb length, shorter trunk, lower trabecular BMD, smaller cortical bone area, and smaller cortical thickness ( p < .005) but not with bone-size-adjusted volumetic BMD (vBMD). With decreasing cortical thickness [odds ratio (OR) 1.4/SD, p .001] and decreasing cortical area (OR 1.5/SD, p .001), fracture odds ratios increased. No association between sex steroid concentrations and prevalent fractures was observed. Childhood fractures ( 15 years) were associated with a thinner bone cortex (À5%, p .005) and smaller periosteal size (À3%, p .005). Fractures occurring later than 15 years of age were associated with a thinner bone cortex (À3%, p .05) and larger endosteal circumference (þ3%, p .05) without differences in periosteal bone size. In conclusion, prevalent fractures in healthy young men are associated with unfavorable bone geometry and not with cortical vBMD when adjusting for bone size. Moreover, the data suggest different mechanisms of childhood fractures and fractures during adult life. ß 2010 American Society for Bone and Mineral Research. KEY WORDS: pQCT; PEAK BONE MASS; OSTEOPOROSIS; MEN; BONE GEOMETRY; FRACTURE IntroductionB one mass at any stage in adult life is determined by the growth and mineralization of the skeleton during the first two decades of life leading to the peak bone mass (PBM) and by subsequent net changes in bone mass, usually bone loss, starting in the middle of the third decade. (1) Although fracture risk in old age is lower in men than in women, fracture risk is higher in boys and young men than in girls or young women. (2,3) In both young and older subjects, low areal bone mineral density (aBMD) has been associated with increased fracture prevalence, although most evidence has been obtained in women (4,5) or elderly men, (6) and only limited data are available in boys or young men. (7)(8)(9) An important limitation of dual-energy X-ray absorptiometry (DXA) is that it measures projected aBMD and not volumetric BMD (vBMD). In determining PBM and future facture risk, this has important clinical implications because bone strength depends not only on the amount of bone tissue but also on the diameter, shape, and volumetric bone...

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Section: Discussionmentioning

confidence: 99%

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Taes

Lapauw

Vanbillemont

et al. 2010

Journal of Bone and Mineral Research

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“…89 The most common fractures in children are located to the upper extremity (distal forearm, fingers, carpal and metacarpal bones and the clavicle . 85,89,97,171,187 Fractures which require in-patient hospital treatment mostly involve the distal forearm, followed by the supracondylar humerus, forearm shaft and tibial shaft. 26 Kopjar estimated that 72% of the child fractures resulted in activity restriction, with leg fractures accounting for 33% of all activity restricted days, although representing only 19% of cases.…”

Section: Child Fracturesmentioning

confidence: 99%

“…26,85,89,97,171,187 Equally reported are also the changes in rates with age. The supracondylar fracture is most common in the first decade of life, with a peak at 7-8.…”

Section: Anatomic Location Of Fractures By Agementioning

confidence: 99%

“…171 In a comparison study of fracture incidences in 1996, extracted from south Wales, Norwegian NISS data (Harstad, Trondheim, Stavanger and Drammen), Swedish data (Jamtland) and Finnish data (Parvoo), the Welsh: Scandinavian fracture ratio was 1.82. 98 The longer season for summer sports in south Wales seemed to outweigh the possible higher risk associated with winter sports in Scandinavia.…”

Section: Fracture Injuriesmentioning

confidence: 99%

“…98 The percentage of fractures in the radius and ulna related to other fracture locations was 39% in our study (27% wrist plus 12% forearm fractures), 36% in south Wales, 98 45% in Nottingham, 187 and 27% in Malmø. 171 Most distal radial fractures are easy to treat with immobilization in a cast for 3-6 weeks, and rarely cause any functional dysfunction for the child. The discussion regarding the treatment of displaced distal and shaft forearm fractures is more complex.…”

Section: Forearm Fracturesmentioning

confidence: 99%

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REVIOUS STUDIES HAVE SHOWNthat the incidence of distal forearm fractures in children peaks during early adolescence around the time of the pubertal growth spurt. [1][2][3] This observation has been explained on the basis of a transient increase in cortical porosity that results from enhanced bone turnover in response to greater calcium demand at the time of maximal longitudinal bone growth. 4 Such a process might be especially problematic given the thin cortex of the metaphyseal region of the distal radius, 5 and growth-related structural changes in the metaphysis further compromise bone strength in the distal forearm. 6 Adolescence is also characterized by the increase in physical activity necessary to maximize skeletal mass. 7-9 Thus, Parfitt 4 has suggested that forearm fractures in adolescence are "an inescapable consequence of an appropriate level of physical activity, and [are] the price that has to be paid in order to maximize bone accumulation during growth and minimize fracture risk in old age." To some extent, then, forearm fractures in adolescence may represent a transient imbalance between physical activity and acquisition of bone mass during puberty. This relationship may have changed over the years, due either to changing patterns of physical activity or to alterations in acquisition of bone mass, related perhaps to changing dietary habits.The incidence of distal forearm fractures among Rochester, Minn, residents younger than 35 years in 1969-1971 was reported previously. 10 The purpose of the present investigation was to estimate the incidence of such fractures among comparable Rochester residents 10, 20, and 30 years later in 1979-

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Decreasing incidence of fractures in children: An epidemiological analysis of 1,673 fractures in Malmö, Sweden, 1993–1994

Cited by 104 publications

References 9 publications

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Child injuries in Bergen, Norway

Incidence of Childhood Distal Forearm Fractures Over 30 Years

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