Humeral Fractures in South-Eastern Australia: Epidemiology and Risk Factors.

In this study, we report the epidemiology and risk factors for humeral fractures (proximal humerus and shaft) among men and women residing in south-eastern Australia. Incident fractures during 2006 and 2007 were identified using X-ray reports (Geelong Osteoporosis Study Fracture Grid). Risk factors were identified using data from case-control studies conducted as part of the Geelong Osteoporosis Study. Median age of fracture was lower in males than females for proximal humerus (33.0 vs 71.2 years), but not for humeral shaft (8.9 vs 8.5 years). For females, proximal humerus fractures occurred mainly in the 70-79 and 80+ years age groups, whereas humeral shaft fractures followed a U-shaped pattern. Males showed a U-shaped pattern for both proximal humerus and humeral shaft fractures. Overall age-standardised incidence rates for proximal humerus fractures in males and females were 40.6 (95% CI 32.7, 48.5) and 73.2 (95% CI 62.2, 84.1) per 100,000 person years, respectively. For humeral shaft fractures, the age-standardised rate was 69.3 (95% CI 59.0, 79.6) for males and 61.5 (95% CI 51.9, 71.0) for females. There was an increase in risk of proximal humerus fractures in men with a lower femoral neck BMD, younger age, prior fracture and higher milk consumption. In pre-menopausal women, increased height and falls were both risk factors for proximal humerus fractures. For post-menopausal women, risk factors associated with proximal humerus fractures included a lower non-milk dairy consumption and sustaining a prior fracture. Humeral shaft fractures in both sexes were sustained mainly in childhood, while proximal humerus fractures were sustained in older adulthood. The overall age-standardised rates of proximal humerus fractures were nearly twice as high in females compared to males, whereas the incidence rates of humeral shaft fractures were similar.

The Epidemiology of Incident Fracture from Cradle to Senescence.

To reduce the burden of fracture, not only does bone fragility need to be addressed, but also injury prevention. Thus, fracture epidemiology irrespective of degree of trauma is informative. We aimed to determine age-and-sex-specific fracture incidence rates for the Barwon Statistical Division, Australia, 2006-2007. Using radiology reports, incident fractures were identified for 5342 males and 4512 females, with incidence of 210.4 (95 % CI 204.8, 216.2) and 160.0 (155.3, 164.7)/10,000/year, respectively. In females, spine (clinical vertebral), hip (proximal femoral) and distal forearm fractures demonstrated a pattern of stable incidence through early adult life, with an exponential increase beginning in postmenopausal years for fractures of the forearm followed by spine and hip. A similar pattern was observed for the pelvis, humerus, femur and patella. Distal forearm, humerus, other forearm and ankle fractures showed incidence peaks during childhood and adolescence. For males, age-related changes mimicked the female pattern for fractures of the spine, hip, ribs, pelvis and humerus. Incidence at these sites was generally lower for males, particularly among the elderly. A similar childhood-adolescent peak was seen for the distal forearm and humerus. For ankle fractures, there was an increase during childhood and adolescence but this extended into early adult life; in contrast to females, there were no further age-related increases. An adolescent-young adult peak incidence was observed for fractures of the face, clavicle, carpal bones, hand, fingers, foot and toe, without further age-related increases. Examining patterns of fracture provides the evidence base for monitoring temporal changes in fracture burden, and for identifying high-incidence groups to which fracture prevention strategies could be directed.

Carpal and scaphoid fracture incidence in south-eastern Australia: an epidemiologic study.

UNLABELLED: Carpal fractures were identified by the Geelong Osteoporosis Study Fracture Grid for 2006-2007. Incidence rates were higher in males than females. Males had a lower median age of fracture than females. Females had more fractures on the left side than males. Most fractures were the result of a fall. PURPOSE: In this study, we report the incidence of carpal bone fractures (scaphoid and non-scaphoid) amongst residents from the Barwon Statistical Division over 2 years. METHODS: X-ray reports from imaging centres in the region were used to identify incident fractures during 2006 and 2007. Data were collected as part of the Geelong Osteoporosis Study Fracture Grid. RESULTS: During 2006 and 2007, there were 171 and 41 carpal fractures in males and females, respectively. Of these, 131 males and 29 females had fractured the scaphoid bone. Females had a higher proportion of left-sided fractures (>70 %) than males (∼40 %). Most fractures were the result of an accidental fall (>87 %). Patterns of incidence for males showed one major peak around 20-29 years. For females, peaks occurred around age 10-19 years and 70-79 years. Incidence rates for males (per 100,000 persons per year) were 54.6 (95 % confidence interval (CI) 53.6, 55.7) and 15.9 (95 % CI 15.4, 16.5) for scaphoid and non-scaphoid fractures, respectively. In females, the corresponding rates were 10.6 (95 % CI 10.2, 11.1) and 4.5 (95 % CI 4.2, 4.8). CONCLUSION: Almost all fractures were the result of a fall. In males, carpal fractures were sustained mainly during early adulthood and in females during adolescence and after menopause. Incidence rates for males were higher than those in females for both scaphoid and non-scaphoid fractures.