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Abstract
Background and purpose Fractures are most common in youth and in the elderly, with differences in incidence over time and between regions. We present the fracture pattern in a population of youths ≤ 19 years of age, who were seen at Umeå University Hospital, Sweden.
Material and methods All injuries seen at the hospital have been recorded in a database since 1993. The data include variables such as age, sex, date, type of injury, mechanism of injury, and treatment. For the period 1993–2007, there were 10,203 injury events that had resulted in at least 1 fracture.
Results The incidence for the whole period was 201/104 person years. The incidence increased by 13% during the period 1998–2007, when we were able to control for registration errors. The most common fracture site was the distal forearm. The most common type of injury mechanism was falling. The peak incidence occurred at 11–12 years in girls and at 13–14 years in boys, with a male-to-female incidence ratio of 1.5. We found variations in mechanisms and activities at injury with age, and over time.
Interpretation Fractures are caused by a combination of intrinsic and extrinsic factors that vary with age. We believe the increase in incidence is partly explained by changes in children's activity patterns over time. Further research may help to identify preventive measures to reduce the number of fractures, in particular those involving hospital care, surgical treatment, and—most importantly—long-term impairment.
Acknowledgments
EMH validated and analyzed the data and performed the revision of fracture localization. EMH, OS, PM, and UB all discussed the analysis and participated in writing the manuscript. All authors approved the final version.
We thank the staff of the emergency department and injury surveillance group at UUH for their work in compiling and maintaining the database, and Magnus Hellström in particular for his help in extracting and organizing the data. Thanks also to Hans Stenlund for his advice concerning the statistical analysis.