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Comparative Study
. 2009 Jan;20(1):47-52.
doi: 10.1007/s00198-008-0627-x. Epub 2008 May 9.

Fracture rates in urban South African children of different ethnic origins: the Birth to Twenty cohort

K Thandrayen  1 , S A Norris, J M Pettifor
Affiliations
Comparative Study

Fracture rates in urban South African children of different ethnic origins: the Birth to Twenty cohort

K Thandrayen et al. Osteoporos Int. 2009 Jan.

Abstract

Fracture rates were compared in children of different ethnic backgrounds from Johannesburg, South Africa. More white children fracture than black and mixed ancestry children. Reasons for this may be due to greater sports participation by whites and genetic protective factors in blacks. This has to be further investigated.

Introduction: Fracture rates in childhood are as high as those in the elderly. Recent research has been undertaken to understand the reasons for this, but there is little information available on ethnic differences in childhood fracture rates.

Methods: Using the birth to twenty longitudinal cohort of children, we retrospectively obtained information on fractures and their sites from birth to 14.9 years of age on 2031 participants. The ethnic breakdown of the children was black (B) 78%, white (W) 9%, mixed ancestry (MA) 10.5% and Indian (I) 1.5%.

Results: Four hundred and forty-one (22%) children had sustained a fracture one or more times during their lifetime (males 27.5% and females 16.3%; p < 0.001). The percentage of children fracturing differed between the ethnic groups (W 41.5%, B 19%, MA 21%, I 30%; p < 0.001). Of the 441 children reporting fractures, 89(20%) sustained multiple fractures. The most common site of fracture was the upper limb (57%).

Conclusion: More white children fracture than black and mixed ancestry children. This is the first study to show ethnic differences in fracture rates among children. The reasons for these differences have to be further elucidated. Greater sports participation by whites and genetic protective factors in blacks may be contributing factors.

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Figures

Fig. 1
Fig. 1
Fracture rates per year by age and ethnicity
Fig. 2
Fig. 2
Fractures per year by age and sex distribution. The number of males and females in the study were similar
Fig. 3
Fig. 3
Fracture rates over 15 years between ethnic groups at the different fracture sites. The p values indicate the significant difference between fracture rates of the white children and those of the black and mixed ancestry children
See this image and copyright information in PMC

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