The 21st century landscape of adult fractures - Cohort study of a complete adult regional population.

• Recent reports on adult fracture epidemiology have focused mainly on the hip in elderly where increasing rates lately have changed to a decline. New reports of the preponderance of non-hip fractures in expenditure call for a wider scope. We therefore examined current overall and site-specific fracture epidemiology in adults. We ascertained all fractures diagnosed in in- and out-patient care in all men and women aged 20 years or older in the Skåne County, Sweden, from year 1999 to 2010 (10 million person-years). For each fracture type, we estimated age- and sex-specific rates and evaluated potential time trends. We found 205 908 fractures yielding an overall fracture rate of 192 per 10 000 person-years. The age standardized overall fracture rate increased with 1.2 per 10 000 and annum (95% confidence interval 0.8 to 1.5), but time trends were different for different fracture types, age strata, and for men and women. For example, in both women and men aged =50 years the rates of proximal humerus fracture increased (0.6 respective 0.2 per 10 000 and year) while hip fracture rates declined (-1.0 respective -0.3 per 10 000 and year). Overall age-specific number of fractures increased with age in women but was stable in men. The increasing overall fracture rate is a major concern in the context of a growing and aging population. Effective and affordable preventive strategies and treatments should be an urgent priority to meet the challenges, especially in older women where most fractures occur. Comprehensive current detailed data, as provided in this study, may serve as reference for projections and for cost-calculations of fracture care in other settings before similar examinations are available there. © 2014 American Society for Bone and Mineral Research.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

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