Epidemiology of childhood fractures in Britain: a study using the general practice research database

Cooper, C., Dennison, E.M., Leufkens, H.G., Bishop, N. and Van Staa, T.P. (2004) Epidemiology of childhood fractures in Britain: a study using the general practice research database. Journal of Bone and Mineral Research, 19, (12), 1976-1981. (doi:10.1359/JBMR.040902).


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Original Publication URL: http://dx.doi.org/10.1359/JBMR.040902


A population-based British cohort study, including 6% of the population, was used to derive age- and sex-specific incidence rates of fractures during childhood. Fractures were more common among boys than girls, with peak incidences at 14 and 11 years of age, respectively. At childhood peak, incidence rates were only surpassed later in life at 85 years of age among women and never among men.

Introduction: Fractures account for 25% of accidents and injuries in childhood; however, the descriptive epidemiology of childhood fractures remains uncertain.

Materials and Methods: Age- and sex-specific incidence rates for fractures at various skeletal sites were derived from the General Practice Research Database (a population-based British cohort containing computerized medical records of 7,000,000 residents) between 1988 and 1998.

Results: A total of 52,624 boys and 31,505 girls sustained one or more fractures over the follow-up period, for a rate of 133.1/10,000 person-years. Fractures were more common in boys (161.6/10,000 person-years) than girls (102.9/10,000 person-years). The most common fracture in both sexes was that of the radius/ulna (30%). Fracture incidence was greater among boys than girls at all ages, with the peak incidence at 14 years of age among boys and 11 years of age among girls. Marked geographic variation was observed in standardized fracture incidence, with significantly (p < 0.01) higher rates observed in Northern Ireland, Wales, and Scotland compared with southeast England.

Conclusions: Fractures are a common problem in childhood, with around one-third of boys and girls sustaining at least one fracture before 17 years of age. Rates are higher among boys than girls, and male incidence rates peak later than those among females. At their childhood peak, the incidence of fractures (boys, 3%; girls, 1.5%) is only surpassed at 85 years of age among women and never among men. The most common site affected in both genders is the radius/ulna. Studies to clarify the pathogenesis of these fractures, emphasizing bone fragility, are now required.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1359/JBMR.040902
ISSNs: 0884-0431 (print)
Related URLs:
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions : University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease
ePrint ID: 25381
Accepted Date and Publication Date:
Date Deposited: 12 Apr 2006
Last Modified: 31 Mar 2016 11:47
URI: http://eprints.soton.ac.uk/id/eprint/25381

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