J Wrist Surg 2021; 10(02): 129-135
DOI: 10.1055/s-0040-1720965
Scientific Article

Childhood Distal Forearm Fracture Incidence in Malmö, Sweden 1950 to 2016

Erika Bergman
1   Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, Malmö, Sweden
,
Vasileios Lempesis
1   Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, Malmö, Sweden
,
Lars Jehpsson
1   Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, Malmö, Sweden
,
Björn E. Rosengren
1   Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, Malmö, Sweden
,
Magnus K. Karlsson
1   Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Skåne University Hospital, Malmö, Sweden
› Institutsangaben
Funding ALF, the Herman Järnhardt Foundation, the Greta and Johan Kock Foundation and Region Skåne FoU provided financial support for the study. The funding sources were not involved in the study design or conduct, in the data acquisition or interpretation or in the writing of the manuscript.

Abstract

Background Distal forearm fracture is the most common pediatric fracture. As studies have indicated time trends in fracture incidence, we wanted to update the epidemiology and estimate time trends between 1950 and 2016 in Malmö, Sweden.

Methods The city of Malmö, Sweden, had 318,107 inhabitants (58,585 of the population was aged <16 years) in 2014 and one hospital. We, therefore, used the hospital diagnosis registry and hospital medical records to identify and classify distal forearm fractures 2014 to 2016 in children aged 0 to 15 years. For long-term trend calculations, we also included published data from 1950 to 2006 (resulting in 17 evaluated years) and used joinpoint regression to estimate annual percent changes (APC). To describe differences in incidence between two periods, we calculated incident rate ratios (IRR) with 95% confidence intervals (95% CI) to describe uncertainty.

Results Childhood distal forearm fracture incidence in 2014 to 2016 was 546/100,000 person-years (660 in boys and 427 in girls). The age-adjusted incidence in 2014 to 2016 and in 2005 to 2006 was similar (boys IRR 1.0, 95% CI: 0.9–1.2 and girls IRR 1.1, 95% CI: 0.9–1.3). Time-trend analyses from 1950 to 2016 revealed increasing age-adjusted incidence in both boys (APC +0.9%, 95% CI: 0.7–1.2) and girls (APC +0.6%, 95% CI: 0.3–0.9).

Conclusion Distal forearm fracture incidence was similar in 2014 to 2016 and in 2005 to 2006. Age-adjusted incidence had increased in both sexes from 1950 to 2016.

Level of Evidence This is a Level III b study.

Ethical Approval

The study was approved by the Regional Ethical Review Board in Lund (reference number 2016/1080) and was conducted according to the Declaration of Helsinki.




Publikationsverlauf

Eingereicht: 31. Mai 2020

Angenommen: 05. Oktober 2020

Artikel online veröffentlicht:
04. Dezember 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Cooper C, Dennison EM, Leufkens HG, Bishop N, van Staa TP. Epidemiology of childhood fractures in Britain: a study using the general practice research database. J Bone Miner Res 2004; 19 (12) 1976-1981
  • 2 Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology of fractures in children and adolescents. Acta Orthop 2010; 81 (01) 148-153
  • 3 Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 1983; 202: 1-109
  • 4 Lempesis V, Rosengren BE, Nilsson JA, Landin L, Tiderius CJ, Karlsson MK. Time trends in pediatric fracture incidence in Sweden during the period 1950-2006. Acta Orthop 2017; 88 (04) 440-445
  • 5 Mäyränpää MK, Mäkitie O, Kallio PE. Decreasing incidence and changing pattern of childhood fractures: a population-based study. J Bone Miner Res 2010; 25 (12) 2752-2759
  • 6 Tiderius CJ, Landin L, Düppe H. Decreasing incidence of fractures in children: an epidemiological analysis of 1,673 fractures in Malmö, Sweden, 1993-1994. Acta Orthop Scand 1999; 70 (06) 622-626
  • 7 Bergman E, Lempesis V, Nilsson JA, Jephsson L, Rosengren BE, Karlsson MK. Time trends in pediatric fractures in a Swedish city from 1950 to 2016. Acta Orthop 2020; •••: 1-10
  • 8 Lempesis V, Jerrhag D, Rosengren BE, Landin L, Tiderius CJ, Karlsson MK. Pediatric distal forearm fracture epidemiology in Malmö, Sweden-time trends during six decades. J Wrist Surg 2019; 8 (06) 463-469
  • 9 Khosla S, Melton III LJ, Dekutoski MB, Achenbach SJ, Oberg AL, Riggs BL. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA 2003; 290 (11) 1479-1485
  • 10 Wilcke MK, Hammarberg H, Adolphson PY. Epidemiology and changed surgical treatment methods for fractures of the distal radius: a registry analysis of 42,583 patients in Stockholm County, Sweden, 2004–2010. Acta Orthop 2013; 84 (03) 292-296
  • 11 Statistics Sweden. Child population/population in the city of Malmö i 1-year classes, December 31st 2014/2015/2016. 2017; Accessed May 25, 2020 at: http://www.statistikdatabasen.scb.se/sq/83864
  • 12 Jørgensen K. Nordisk Medicinal-Statistisk K. NOMESCO classification of external causes of injuries. Fourth revised edition. 2007 ; Accessed May 25, 2020 at: https://norden.diva-portal.org/smash/get/diva2:1201255/FULLTEXT01.pdf
  • 13 Joinpoint Regression Program, Version 4.7.0.0 - February 2019; Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute
  • 14 Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19: 335-351 : (correction: 2001;20:655)
  • 15 Mamoowala N, Johnson NA, Dias JJ. Trends in paediatric distal radius fractures: an eight-year review from a large UK trauma unit. Ann R Coll Surg Engl 2019; 101 (04) 297-303
  • 16 Christoffersen T, Ahmed LA, Winther A. et al. Fracture incidence rates in Norwegian children, The Tromsø Study, Fit Futures. Arch Osteoporos 2016; 11 (01) 40
  • 17 Randsborg PH, Gulbrandsen P, Saltytė Benth J. et al. Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am 2013; 95 (07) e42
  • 18 Jerrhag D, Englund M, Petersson I. et al. Increasing wrist fracture rates in children may have major implications for future adult fracture burden. Acta Orthop 2016; 87 (03) 296-300
  • 19 Hedström EM, Waernbaum I. Incidence of fractures among children and adolescents in rural and urban communities - analysis based on 9,965 fracture events. Inj Epidemiol 2014; 1 (01) 14
  • 20 Lempesis V. Epidemiology and etiology of childhood fractures in southern Sweden [Ph.D. dissertation]. Lund: Faculty of Medicine, Lund University; 2018
  • 21 Moon RJ, Harvey NC, Curtis EM, de Vries F, van Staa T, Cooper C. Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom. Bone 2016; 85: 9-14
  • 22 Park MS, Chung CY, Choi IH. et al. Incidence patterns of pediatric and adolescent orthopaedic fractures according to age groups and seasons in South Korea: a population-based study. Clin Orthop Surg 2013; 5 (03) 161-166
  • 23 Raustorp A, Fröberg A. Comparisons of pedometer-determined weekday physical activity among Swedish school children and adolescents in 2000 and 2017 showed the highest reductions in adolescents. Acta Paediatr 2019; 108 (07) 1303-1310
  • 24 Swedish Media Council. Kids and Media 2017. 2017 ; Accessed May 25, 2020 at: https://statensmedierad.se/download/18.7b0391dc15c38ffbccd9a238/1496243409783/Ungar%20och%20medier%202017.pdf
  • 25 Fritz J, Cöster ME, Nilsson JA, Rosengren BE, Dencker M, Karlsson MK. The associations of physical activity with fracture risk--a 7-year prospective controlled intervention study in 3534 children. Osteoporos Int 2016; 27 (03) 915-922
  • 26 Clark EM, Ness AR, Tobias JH. Vigorous physical activity increases fracture risk in children irrespective of bone mass: a prospective study of the independent risk factors for fractures in healthy children. J Bone Miner Res 2008; 23 (07) 1012-1022
  • 27 Jonsson B. Life style and fracture risk. [Ph.D. dissertation] Malmö General Hospital, University of Lund; 1993