Incidence and characteristics of distal radius fractures in a southern Swedish region
Tóm tắt
The incidence of distal radius fracture has increased substantially during the last 50 years according to several studies that estimated the overall incidence in various general populations. The incidence of fracture classified according to severity has not been well documented. The aim of this population-based study was to estimate the overall and type-specific incidence rates of distal radius fracture in a representative population in southern Sweden. During 2001, all persons older than 18 years with acute distal radius fracture in the southern Swedish region of Northeastern Scania were prospectively recorded. A radiologist classified the fractures according to the AO system and measured volar tilt and ulnar variance. A fracture with volar tilt outside a range of -5° to 20° and/or ulnar variance of 2 mm or greater was defined as displaced. 335 persons with acute distal radius fracture were recorded during the 1-year period. The overall incidence rate was 26 (95% confidence interval 23–29) per 10,000 person-years. Among women the incidence rate increased rapidly from the age of 50 and reached a peak of 119 per 10,000 person-years in women 80 years and older. The incidence rate among women 50 to 79 years old (56 per 10,000 person-years) was lower than that reported in previous studies of similar populations. Among men the incidence rate was low until the age of 80 years and older when it increased to 28 per 10,000 person-years. Fractures classified as AO type A comprised about 80% of the fractures in women and 64% in men. Almost two-thirds of all fractures were displaced and among men and women 80 years and older more than 80% of the fractures were displaced. The incidence rate of distal radius fracture in women 50 to 79 years old was lower than previously reported, which may indicate declining incidence in this group. In both sexes, the incidence was highest in the age group of 80 years and older. With a growing number of elderly in the general population, the impact of distal radius fracture in the future may be considerable.
Tài liệu tham khảo
Bengner U, Johnell O: Increasing incidence of forearm fractures. A comparison of epidemiologic patterns 25 years apart. Acta Orthop Scand. 1985, 56: 158-160.
Melton LJ, Amadio PC, Crowson CS, O'Fallon WM: Long-term trends in the incidence of distal forearm fractures. Osteoporos Int. 1998, 8: 341-348. 10.1007/s001980050073.
Falch JA: Epidemiology of fractures of the distal forearm in Oslo, Norway. Acta Orthop Scand. 1983, 54: 291-295.
Hove LM, Fjeldsgaard K, Reitan R, Skjeie R, Sorensen FK: Fractures of the distal radius in a Norwegian city. Scand J Plast Reconstr Surg Hand Surg. 1995, 29: 263-267.
Mallmin H, Ljunghall S: Incidence of Colles' fracture in Uppsala. A prospective study of a quarter-million population. Acta Orthop Scand. 1992, 63: 213-215.
Solgaard S, Petersen VS: Epidemiology of distal radius fractures. Acta Orthop Scand. 1985, 56: 391-393.
Thompson PW, Taylor J, Dawson A: The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK. Injury. 2004, 35: 462-466. 10.1016/S0020-1383(03)00117-7.
Melton LJ, Crowson CS, O'Fallon WM: Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int. 1999, 9: 29-37. 10.1007/s001980050113.
Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA: Fracture rates lower in rural than urban communities: the Geelong Osteoporosis Study. J Epidemiol Community Health. 2002, 56: 466-470. 10.1136/jech.56.6.466.
Ismail AA, Pye SR, Cockerill WC, Lunt M, Silman AJ, Reeve J, Banzer D, Benevolenskaya LI, Bhalla A, Bruges AJ, Cannata JB, Cooper C, Delmas PD, Dequeker J, Dilsen G, Falch JA, Felsch B, Felsenberg D, Finn JD, Gennari C, Hoszowski K, Jajic I, Janott J, Johnell O, Kanis JA, Kragl G, Lopez VA, Lorenc R, Lyritis G, Marchand F, Masaryk P, Matthis C, Miazgowski T, Naves-Diaz M, Pols HA, Poor G, Rapado A, Raspe HH, Reid DM, Reisinger W, Scheidt-Nave C, Stepan J, Todd C, Weber K, Woolf AD, O'Neill TW: Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int. 2002, 13: 565-571. 10.1007/s001980200074.
McKay SD, MacDermid JC, Roth JH, Richards RS: Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg (Am). 2001, 26 (5): 916-922. 10.1053/jhsu.2001.26662.
Cooney CWP 3rd, Dobyns JH, Linscheid RL: Complications of Colles' fractures. J Bone Joint Surg (Am). 1980, 62 (4): 613-619.
Robertsson GO, Jonsson GT, Sigurjonsson K: Epidemiology of distal radius fractures in Iceland in 1985. Acta Orthop Scand. 1990, 61: 457-459.
Schmalholz A: Epidemiology of distal radius fracture in Stockholm 1981-82. Acta Orthop Scand. 1988, 59: 701-703.
Fernandez DL, Palmer AK: Fractures of the distal radius. Green's Operative Hand Surgery. 1999, Churchill Livingstone, 929-985. 4th Edition
Andersen DJ, Blair WF, Steyers CM J, Adams BD, el-Khouri GY, Brandser EA: Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. J Hand Surg (Am). 1996, 21 (4): 574-582. 10.1016/S0363-5023(96)80006-2.
Karnezis IA: Correlation between wrist loads and the distal radius volar tilt angle. Clin Biomech (Bristol, Avon). 2005, 20: 270-276. 10.1016/j.clinbiomech.2004.10.004.
Sanden B, Lindsjo U: It is possible to reduce the number of wrongly healed fractures of the radius. Prognosis assessment during the first consultation, individualized treatment later. Läkartidningen. 1998, 95 (30-31): 3270-3272.
Beumer A, McQueen MM: Fractures of the distal radius in low-demand elderly patients: closed reduction of no value in 53 of 60 wrists. Acta Orthop Scand. 2003, 74: 98-100. 10.1080/00016470310013743.
O'Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, Rowe R, Woolf AD, Wallace WA: Incidence of distal forearm fracture in British men and women. Osteoporos Int. 2001, 12: 555-558. 10.1007/s001980170076.
Statistics Sweden. Population statisitics. 2006, [http://www.ssd.scb.se/databaser/makro/start.asp]
Miller SW, Evans JG: Fractures of the distal forearm in Newcastle: an epidemiological survey. Age Ageing. 1985, 14: 155-158. 10.1093/ageing/14.3.155.
Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002, 359: 1761-1767. 10.1016/S0140-6736(02)08657-9.
Davies JC, Manning DP, Kemp GJ, Frostick SP: The rising number of underfoot accidents after the menopause causes both fractures and non-fracture injuries. QJM. 2001, 94: 699-707. 10.1093/qjmed/94.12.699.
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