Stabilizing incidence of low-trauma ankle fractures in elderly people Finnish statistics in 1970-2006 and prediction for the future

Abstract

Introduction: Low-trauma fractures of older adults have been recognized as a major public health problem in developed societies with aging populations. However, nationwide information on recent fracture trends is rather scarce.

Methods: We determined the trend in the number and incidence (per 100,000 persons) of low-trauma ankle fracture among elderly people in Finland by taking into account all persons 60 years of age or older who were admitted to our hospitals for primary treatment of such fracture in 1970-2006.

Results: The number of low-trauma ankle fractures among 60-year-old or older Finnish persons increased steadily and sharply between 1970 (369 fractures) and 1997 (1668 fractures), but since then, the increase has leveled off (1670 fractures in 2006). The raw incidence of low-trauma ankle fracture, showing a clear rise from 57 fractures per 100,000 persons in 1970 to 169 fractures in 1997, somewhat decreased between 1997 and 2006 (to 144 fractures in 2006). Observations on the age-adjusted fracture incidence were similar. During 1970-1997, the age-adjusted incidence of low-trauma ankle fracture clearly rose in both women and men, but thereafter, the incidence declined; in women, from 199 in 1997 to 173 in 2006, and in men, from 123 in 1997 to 100 in 2006.

Conclusions: The sharp increase in the incidence of low-trauma ankle fracture in Finnish older adults from early 1970s until late 1990s has been followed by stabilized, slightly declining fracture rates. Reasons for this are not known, but a cohort effect toward a healthier aging population with improved functional ability and reduced risk of injurious slips, trips and falls could partly explain the phenomenon.