Advanced

Epidemiology and etiology of childhood fractures in southern Sweden

Lempesis, Vasileios LU (2018)
Abstract (Swedish)
Background: As much as 40–50% of children are expected to sustain fractures during growth. A childhood fracture is also
associated with high risk of fractures in adult life. Previous research has shown that fracture incidence has not been stable and
some studies suggest that this has also continued during recent decades.
Aims: The aim of this thesis was therefore to describe fracture epidemiology and etiology in children in Malmö, Sweden, in
2005–2006. We also wanted to make historical comparisons, to be able to estimate fracture time trends in the pediatric city
population, and investigate time trends in the epidemiology of pediatric distal forearm fractures in the county of Skåne.
Methods: In papers I, III, IV we... (More)
Background: As much as 40–50% of children are expected to sustain fractures during growth. A childhood fracture is also
associated with high risk of fractures in adult life. Previous research has shown that fracture incidence has not been stable and
some studies suggest that this has also continued during recent decades.
Aims: The aim of this thesis was therefore to describe fracture epidemiology and etiology in children in Malmö, Sweden, in
2005–2006. We also wanted to make historical comparisons, to be able to estimate fracture time trends in the pediatric city
population, and investigate time trends in the epidemiology of pediatric distal forearm fractures in the county of Skåne.
Methods: In papers I, III, IV we identified fractures in children (age<16 years) in the city of Malmö during the years 2005–
2006 through the diagnosis registry, medical charts and radiographic archives of the hospital. We then calculated crude and agestandardized
fracture rates and made comparisons with previously collected and published pediatric fracture data from 12
sample years during the period 1950 to 1994. In Paper II we used data from the SHR, an official database of in- and outpatient
care episodes in the county of Skåne, Sweden, to ascertain distal forearm fractures in children (<17 years of age) that occurred
between 1999 and 2010.
Results: In paper I, we found that the rate of pediatric fractures in the city of Malmö in 2005–2006 was 1832 per 105 patient
years (2359 in boys and 1276 in girls). Fractures were more common in boys than in girls (age-adjusted fracture RR 1.8; 95%
CI 1.6 to 2.1) and the most common fracture types were the distal forearm (31%), the phalanges of the digits (15%), and the
metacarpals (10%). Fractures in which the etiology could be determined occurred most often during sports, playing or in traffic.
The age- and gender-adjusted incidence in children in 2005–2006 did not differ significantly from 1993–1994 (RR 0.9; 95% CI
0.8 to 1.03).The age-adjusted incidence in girls was however lower (RR 0.8; 95% CI 0.7 to 0.99) with no evident change in
boys (RR 1.0; 95% CI 0.9 to 1.1). In paper II, the rate of pediatric distal forearm fractures in the county of Skåne, Sweden,
1999–2010 was 634 per 105 person years (750 in boys and 512 in girls), with a significant increase of 2.2% (95% CI 1.7 to 2.6)
per 105 persons per year during the period of observation ((RR 2.0%; 95% CI: 1.5 to 2.6) in boys and (RR 2.4%: 95% CI: 1.7 to
3.1) in girls). In paper III, we found that the pediatric distal forearm fracture incidence in the city of Malmö in 2005–2006 was
564 per 105 person years (719 in boys and 401 in girls). The age- and gender-adjusted incidence in children in 2005–2006 did
not differ significantly from 1993–1994 (RR 1.1; 95% CI 0.9 to 1.3), neither in boys (RR 1.2; 95% CI 0.98 to 1.6) nor in girls
(RR 0.8; 95% CI 0.6 to 1.1). In paper IV, we found that the pediatric hand fracture incidence in the city of Malmö in 2005–2006
was 448 per 105 person years (639 in boys and 247 in girls). The age- and gender-adjusted hand fracture incidence in children in
2005–2006 did not differ significantly from 1993–1994 (RR 1.0; 95% CI 0.7 to 1.1), neither in girls (RR 0.8; 95% CI 0.5 to 1.1)
nor in boys (RR 0.9; 95% CI 0.7 to 1.2)
Conclusion: The incidence of pediatric fractures in Malmö in 2005–2006, was higher in boys than in girls and the overall
incidence in children was no different in 2005–2006 compared to 1993–1994. The incidence of pediatric distal forearm fractures (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Associate Professor Sayed-Noor, Arkan, Institutionen för klinisk forskning och utbildning, Södersjukhuset, Karolinska Institutet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
CHILDREN, Boys, Etiology, Girls, Epidemiology, fractures, trends, distal forearm, hand, phalanges, metacarpals
pages
125 pages
publisher
Lund University, Faculty of Medicine
defense location
Ortopedens Föreläsningssal, Inga Marie Nilssons gata 22, Malmö
defense date
2018-05-11 09:00
ISBN
978-91-7619-613-7
language
Swedish
LU publication?
yes
id
4427e787-d9bd-40db-b814-e22040754308
date added to LUP
2018-04-24 13:34:03
date last changed
2018-05-15 10:31:11
@phdthesis{4427e787-d9bd-40db-b814-e22040754308,
  abstract     = {Background: As much as 40–50% of children are expected to sustain fractures during growth. A childhood fracture is also<br>
associated with high risk of fractures in adult life. Previous research has shown that fracture incidence has not been stable and<br>
some studies suggest that this has also continued during recent decades.<br>
Aims: The aim of this thesis was therefore to describe fracture epidemiology and etiology in children in Malmö, Sweden, in<br>
2005–2006. We also wanted to make historical comparisons, to be able to estimate fracture time trends in the pediatric city<br>
population, and investigate time trends in the epidemiology of pediatric distal forearm fractures in the county of Skåne.<br>
Methods: In papers I, III, IV we identified fractures in children (age&lt;16 years) in the city of Malmö during the years 2005–<br>
2006 through the diagnosis registry, medical charts and radiographic archives of the hospital. We then calculated crude and agestandardized<br>
fracture rates and made comparisons with previously collected and published pediatric fracture data from 12<br>
sample years during the period 1950 to 1994. In Paper II we used data from the SHR, an official database of in- and outpatient<br>
care episodes in the county of Skåne, Sweden, to ascertain distal forearm fractures in children (&lt;17 years of age) that occurred<br>
between 1999 and 2010.<br>
Results: In paper I, we found that the rate of pediatric fractures in the city of Malmö in 2005–2006 was 1832 per 105 patient<br>
years (2359 in boys and 1276 in girls). Fractures were more common in boys than in girls (age-adjusted fracture RR 1.8; 95%<br>
CI 1.6 to 2.1) and the most common fracture types were the distal forearm (31%), the phalanges of the digits (15%), and the<br>
metacarpals (10%). Fractures in which the etiology could be determined occurred most often during sports, playing or in traffic.<br>
The age- and gender-adjusted incidence in children in 2005–2006 did not differ significantly from 1993–1994 (RR 0.9; 95% CI<br>
0.8 to 1.03).The age-adjusted incidence in girls was however lower (RR 0.8; 95% CI 0.7 to 0.99) with no evident change in<br>
boys (RR 1.0; 95% CI 0.9 to 1.1). In paper II, the rate of pediatric distal forearm fractures in the county of Skåne, Sweden,<br>
1999–2010 was 634 per 105 person years (750 in boys and 512 in girls), with a significant increase of 2.2% (95% CI 1.7 to 2.6)<br>
per 105 persons per year during the period of observation ((RR 2.0%; 95% CI: 1.5 to 2.6) in boys and (RR 2.4%: 95% CI: 1.7 to<br>
3.1) in girls). In paper III, we found that the pediatric distal forearm fracture incidence in the city of Malmö in 2005–2006 was<br>
564 per 105 person years (719 in boys and 401 in girls). The age- and gender-adjusted incidence in children in 2005–2006 did<br>
not differ significantly from 1993–1994 (RR 1.1; 95% CI 0.9 to 1.3), neither in boys (RR 1.2; 95% CI 0.98 to 1.6) nor in girls<br>
(RR 0.8; 95% CI 0.6 to 1.1). In paper IV, we found that the pediatric hand fracture incidence in the city of Malmö in 2005–2006<br>
was 448 per 105 person years (639 in boys and 247 in girls). The age- and gender-adjusted hand fracture incidence in children in<br>
2005–2006 did not differ significantly from 1993–1994 (RR 1.0; 95% CI 0.7 to 1.1), neither in girls (RR 0.8; 95% CI 0.5 to 1.1)<br>
nor in boys (RR 0.9; 95% CI 0.7 to 1.2)<br>
Conclusion: The incidence of pediatric fractures in Malmö in 2005–2006, was higher in boys than in girls and the overall<br>
incidence in children was no different in 2005–2006 compared to 1993–1994. The incidence of pediatric distal forearm fractures},
  author       = {Lempesis, Vasileios},
  isbn         = {978-91-7619-613-7},
  keyword      = {CHILDREN,Boys,Etiology,Girls,Epidemiology,fractures,trends, distal forearm,hand,phalanges,metacarpals},
  language     = {swe},
  pages        = {125},
  publisher    = {Lund University, Faculty of Medicine},
  school       = {Lund University},
  title        = {Epidemiology and etiology of childhood fractures in southern Sweden},
  year         = {2018},
}