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Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS)

Ismail, A.A., Pye, S.R., Cockerill, W.C., Lunt, M., Silman, A.J., Reeve, J., Banzer, D., Benevolenskaya, L.I., Bhalla, A., Bruges Armas, J., Cannata, J.B., Cooper, C., Delmas, P.D., Dequeker, J., Dilsen, G., Falch, J.A., Felsch, B., Felsenberg, D., Finn, J.D., Gennari, C., Hoszowski, K., Jajic, I., Janott, J., Johnell, O., Kanis, J.A., Kragl, G., Lopez Vaz, A., Lorenc, R., Lyritis, G.F., Masaryk, P., Matthis, C., Miazgowski, T., Naves-Diaz, M., Pols, H.A., Poor, G., Rapado, A., Raspe, H.H., Reid, D.M., Reisinger, W., Scheidt-Nave, C., Stepan, J., Todd, C., Weber, K., Woolf, A.D. and O'Neill, T.W. (2002) Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS) Osteoporosis International, 13, (7), pp. 565-571. (doi:10.1007/s001980200074).

Record type: Article


The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50-79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures.
Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7.3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2.5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age.
Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions, though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender.

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Published date: 2002
Keywords: epidemiology, europe, incidence, limb fracture, osteoporosis


Local EPrints ID: 25649
ISSN: 0937-941X
PURE UUID: 6ed7a804-968e-40fd-b388-fda792054381
ORCID for C. Cooper: ORCID iD

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Date deposited: 21 Apr 2006
Last modified: 17 Jul 2017 16:09

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Author: A.A. Ismail
Author: S.R. Pye
Author: W.C. Cockerill
Author: M. Lunt
Author: A.J. Silman
Author: J. Reeve
Author: D. Banzer
Author: L.I. Benevolenskaya
Author: A. Bhalla
Author: J. Bruges Armas
Author: J.B. Cannata
Author: C. Cooper ORCID iD
Author: P.D. Delmas
Author: J. Dequeker
Author: G. Dilsen
Author: J.A. Falch
Author: B. Felsch
Author: D. Felsenberg
Author: J.D. Finn
Author: C. Gennari
Author: K. Hoszowski
Author: I. Jajic
Author: J. Janott
Author: O. Johnell
Author: J.A. Kanis
Author: G. Kragl
Author: A. Lopez Vaz
Author: R. Lorenc
Author: G.F. Lyritis
Author: P. Masaryk
Author: C. Matthis
Author: T. Miazgowski
Author: M. Naves-Diaz
Author: H.A. Pols
Author: G. Poor
Author: A. Rapado
Author: H.H. Raspe
Author: D.M. Reid
Author: W. Reisinger
Author: C. Scheidt-Nave
Author: J. Stepan
Author: C. Todd
Author: K. Weber
Author: A.D. Woolf
Author: T.W. O'Neill

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