Incidence of Limb Fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS)

Abstract

The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50-79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures. Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7.3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2.5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age. Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions, though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender.

Geographic variation of bone mineral density and selected risk factors for prediction of incident fracture among Canadians 50 and older

“…The magnitude of the geographic variation of fractures within CaMos was smaller than noted in previous international studies [2,5,11,25], but comparable to the magnitude of variation found in other North American studies [33,34]. The pattern of geographic variation in incident low-trauma fracture was similar to the pattern of prevalent low-trauma fracture for both men and women.…”

“…The upper limits of the 95% confidence intervals are indicated by error bars. Difference between center specific and overall age-standardized mean total hip BMD (g/cm 2 ) among CaMos participants ages 50 and over at baseline Difference between center specific and overall age-standardized mean lumbar spine BMD (g/cm 2 ) among CaMos participants ages 50 and over at baseline Bone. Author manuscript; available in PMC 2016 November 08.…”

“…Vertebral and non-vertebral fracture rates are known to vary between populations world wide [1][2][3] with countries of northern Europe having the highest fracture rate [4,5]. For example, the age-adjusted rate of hip fracture in women is reported to be 10 times greater in Sweden than in Poland or Malta [6], and the incidence of vertebral compression fracture in men and women is greater in Sweden than in the rest of Europe [7].…”

High incidence of vertebral and non-vertebral fractures in the ostra-cohort study: A 5year follow-up study in postmenopausal women with rheumatoid arthritis

“…When comparing our annual incidence of 3.1 per 100 patients/year with the incidence from the female population in the EPOS study (1.9/100 patient years), it is considerably higher. The EPOS is a study investigating limb fractures in men and women aged 50 to 79 years [17]. Finigan et al also found an incidence 1.9 of new vertebral fractures per 100 patient years in a 10-year follow-up populationbased study.…”

Distal radius fractures in the athlete

“…In the older adult, osteoporosis and poor postural stability are associated with these fractures after falls onto an outstretched hand [1,[6][7][8]9•]. Distal radius fracture in young patients usually occurs in the setting of play or sports and accounts for 23% of all sports-related fractures in adolescents [10].…”