Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr:85:9-14.
doi: 10.1016/j.bone.2016.01.015. Epub 2016 Jan 21.

Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom

Rebecca J Moon  1 , Nicholas C Harvey  2 , Elizabeth M Curtis  3 , Frank de Vries  4 , Tjeerd van Staa  5 , Cyrus Cooper  6
Affiliations

Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom

Rebecca J Moon et al. Bone. 2016 Apr.

Abstract

Background: Fractures are common in childhood, and there is considerable variation in the reported incidence across European countries, but few data relating to ethnic and geographic differences within a single country. We therefore aimed to determine the incidence of childhood fractures in the United Kingdom (UK), and to describe age-, ethnicity- and region- specific variations.

Methods: The Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records for approximately 7% of the UK population. The occurrence of a fracture between 1988 and 2012 was determined from the CPRD for all individuals <18years of age, and used to calculate fracture incidence rates for age, sex and ethnicity. Regional fracture incidence rates were also calculated based on general practitioner location within 14 Strategic Health Authorities (SHA) within the UK.

Results: The overall fracture incidence rate was 137 per 10,000 person-years (py). This was higher in boys (169 per 10,000 py) than girls (103 per 10,000 py) and white children (150 per 10,000 py) compared to those of black (64 per 10,000 py) and South Asian (81 per 10,000 py) ethnicity. Marked geographic variation in incidence was observed. The highest fracture rates were observed in Wales, where boys and girls had 1.82 and 1.97 times greater incidence, respectively, than those residing in Greater London.

Conclusion: In the period 1988-2012, there was marked geographic and ethnic variation in childhood fracture incidence across the UK. These findings also implicate lifestyle and socio-economic differences associated with location and ethnicity, and are relevant to policy makers in the UK and internationally.

Keywords: CPRD; Children; Epidemiology; Ethnicity; Fracture; Osteoporosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age and sex specific incidence rates of fractures at any sites, 1998-2012
Figure 2
Figure 2
Regional variation in fracture incidence in boys and girls within the UK, shown as relative rate of fractures for each sex compared to that observed in Greater London.
Figure 3
Figure 3
Childhood fracture incidence stratified by ethnicity in the UK, 1988-2012
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kopjar B, Wickizer TM. Fractures among children: incidence and impact on daily activities. Inj Prev. 1998;4:194–7. - PMC - PubMed
    1. Morris MWJ, Bell MJ. The socio-economical impact of paediatric fracture clinic appointments. Injury. 2006;37:395–397. - PubMed
    1. Pye SR, Tobias J, Silman AJ, Reeve J, O'Neill TW. Childhood Fractures Do Not Predict Future Fractures: Results From the European Prospective Osteoporosis Study. J Bone Miner Res. 2009;24:1314–1318. - PubMed
    1. Chevalley T, Bonjour JP, van Rietbergen B, Rizzoli R, Ferrari S. Fractures in healthy females followed from childhood to early adulthood are associated with later menarcheal age and with impaired bone microstructure at peak bone mass. J Clin Endocrinol Metab. 2012;97:4174–81. - PubMed
    1. Amin S, Melton LJ, Achenbach SJ, Atkinson EJ, Dekutoski MB, Kirmani S, Fischer PR, Khosla S. A distal forearm fracture in childhood is associated with an increased risk for future fragility fractures in adult men, but not women. J Bone Miner Res. 2013;28:1751–1759. - PMC - PubMed

Publication types