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Epidemiology of low-energy fracture in Chinese postmenopausal women: changing trend of incidence since menopause and associated risk factors, a national population-based survey. Menopause 2020; 26:286-292. [PMID: 30325792 DOI: 10.1097/gme.0000000000001211] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to report the incidence of low-energy fracture since menopause in postmenopausal women ≤70 years and to explore associated risk factors METHODS:: This was a part of the Chinese National Fracture Survey (CNFS), which was carried out in eight provinces of China mainland between January and May 2015. Data on 68,783 postmenopausal women ≤70 years were extracted from the CNFS database for calculations and analyses. RESULTS A total of 309 women were confirmed to have low-energy fractures in 2014, indicating the incidence of 449.2 (95% CI, 399.3-499.2) per 100,000 women. There were two obvious peaks of fracture incidence at the 4th year and the 9th year since menopause. From the 10th year on, the fracture incidence rate presented the relatively steady trends over years, only with slight interannual fluctuation. After adjustment for confounding variables, advanced age, higher latitude, milk intake ≥1/d, residence ≥2nd floor without elevator, alcohol consumption, sleep duration <7 h/d, history of past fracture, and more births were identified as significant risk factors. Supplementation of calcium or vitamin D or both was associated with 44% of fracture reduction (OR, 0.56; 95% CI, 0.37-0.84). CONCLUSIONS These data on low-energy fractures in postmenopausal women provided an updated clinical evidence base for better national healthcare planning and preventive efforts in China.
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Zhu Y, Xing X, Liu S, Chen W, Zhang X, Zhang Y. Epidemiology of low-energy wrist, hip, and spine fractures in Chinese populations 50 years or older: A national population-based survey. Medicine (Baltimore) 2020; 99:e18531. [PMID: 32000361 PMCID: PMC7004702 DOI: 10.1097/md.0000000000018531] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 10/22/2019] [Accepted: 12/01/2019] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to investigate the incidence of low-energy fracture of wrist, hip, and spine and the related risk factors in Chinese populations 50 years or older.This study was a part of the Chinese National Fracture Survey (CNFS) carried out in 8 Chinese provinces in 2015. Data on 154,099 Chinese men and women 50 years or older were extracted from the CNFS database for calculations and analyses. Low-energy fracture was defined as fracture caused by slip, trip, or falls from standing height.A total of 247 patients sustained low-energy fractures in 2014, indicating the incidence rate was 160.3/100,000 person-years, with 120.0 [95% confidence interval (CI), 95.5-144.5] and 213.1(95% CI, 180.7-245.6)/100,000 person-years in men and women, respectively. In men, advanced age, alcohol consumption, residence at second floor or above without elevator, sleep duration <7 h/day, and history of past fracture were identified to be significant risk factors for low-energy fractures. In women, advanced age, living in east region, higher latitude zone (40°N -49.9°N), alcohol consumption, more births, sleep duration <7 h/day, and history of past fracture were identified as significant risk factors. Supplementation of calcium or vitamin D or both was identified to be associated with reduced risk of fracture in women (odds ratio, 0.38; 95% CI, 0.20-0.75), but not in men.These epidemiologic data on low-energy fractures provided updated clinical evidence base for national healthcare planning and preventive efforts in China. Corresponding interventions such as decreasing alcohol consumption and sleep improvement should clearly be implemented. For women, especially those with more births and past history of fracture, routine screening of osteoporosis, and intensive nourishment since menopause should be advocated.
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Affiliation(s)
- Yanbin Zhu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University
- Key Laboratory of Biomechanics of Hebei Province
| | - Xin Xing
- Key Laboratory of Biomechanics of Hebei Province
| | - Song Liu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University
- Key Laboratory of Biomechanics of Hebei Province
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University
- Key Laboratory of Biomechanics of Hebei Province
| | - Xiaolin Zhang
- Department of Statistics and Epidemiology, Hebei Medical University, Shijiazhuang, Hebei
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University
- Key Laboratory of Biomechanics of Hebei Province
- Chinese Academy of Engineering, Beijing, P.R. China
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Malmir H, Larijani B, Esmaillzadeh A. Consumption of milk and dairy products and risk of osteoporosis and hip fracture: a systematic review and Meta-analysis. Crit Rev Food Sci Nutr 2019; 60:1722-1737. [DOI: 10.1080/10408398.2019.1590800] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hanieh Malmir
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Does socioeconomic status influence the epidemiology and outcome of distal radial fractures in adults? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017. [PMID: 28638948 DOI: 10.1007/s00590-017-2003-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study in adult patients with a distal radial fracture was to determine whether socioeconomic status influenced the epidemiology, mechanism of injury, fracture severity, or the outcome according to function, radiographic assessment, and rate of associated complications. METHODS We identified 3983 distal radial fractures over a 7-year period. Socioeconomic status was assigned using the Carstairs score, and the population was divided into quintiles depending on deprivation. Patient demographics, mechanism of injury, fracture severity, and radiographic assessment at time of injury were assessed for epidemiological differences according to social quintile. Functional outcome was assessed using grip strength, Moberg pickup test, return to normal use of the hand, and range of movement. Radiographs were assessed at 1 week, 6 weeks, and 1 year. Complications were defined as malunion, carpal tunnel syndrome, complex regional pain syndrome (CRPS), persistent pain, and subjective cosmetic deformity of the wrist. RESULTS Socioeconomically deprived patients were significantly younger (p < 0.001) and more likely to be male (p = 0.017); after adjusting for confounding factors, deprived patients were 3.1 (95% CI 1.4-4.7) years younger than the most affluent patients (p < 0.001). Deprived patients were more likely to sustain their fracture by a high-energy mechanism (p = 0.004). There were no significant differences between quintiles in outcome. There was a significantly greater prevalence of CRPS in more affluent patients (p = 0.004). CONCLUSIONS Socioeconomically deprived patients sustaining a distal radial fracture are more likely to be younger and male. Outcome is not influenced by socioeconomic status, but the prevalence of CRPS is greater in more affluent patients.
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Thorin MH, Wihlborg A, Åkesson K, Gerdhem P. Smoking, smoking cessation, and fracture risk in elderly women followed for 10 years. Osteoporos Int 2016; 27:249-55. [PMID: 26302684 DOI: 10.1007/s00198-015-3290-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/11/2015] [Indexed: 01/01/2023]
Abstract
UNLABELLED This study examines the impact of smoking and smoking cessation on fracture risk in 75-year-old women followed for 10 years. Smoking increased fracture risk, especially for vertebral fractures. Smoking cessation decreased the risk for vertebral fractures but not for other fracture types. INTRODUCTION The purpose of this study was to examine effects of smoking and smoking cessation on fracture risk. METHODS This prospective observational population-based study followed 1033 women during 10 years from age 75. Data regarding smoking were collected at age 75. Hazard ratios (HRs) and 95 % confidence intervals for fracture were calculated using competing risks proportional hazards regression. RESULTS Both former smokers and current smokers had an increased risk for any fracture (HR 1.30; 1.03-1.66, and HR 1.32; 1.01-1.73, respectively) and any osteoporotic fracture (hip, proximal humerus, distal radius, vertebra) (HR 1.31; 1.01-1.70 and HR 1.49; 1.11-1.98, respectively) compared to non-smokers. Former smokers had an increased risk for proximal humerus fractures (HR 2.23; 1.35-3.70), and current smokers had an increased risk for vertebral fractures (HR 2.30; 1.57-3.38) compared to non-smokers. After adjustment for weight, previous fractures, alcohol habits, bone mineral density (BMD), use of corticoids, vitamin D, bisphosphonates, and previous falls, former smokers had an increased risk for proximal humerus fracture (HR 2.07; 1.19-3.57) and current smokers had an increased risk for osteoporotic (HR 1.47; 1.05-2.05) and vertebral fractures (HR 2.50; 1.58-3.95) compared to non-smokers. Former smokers had a decreased risk for vertebral fractures, but not for other types of fractures, compared to current smokers. CONCLUSIONS Smoking increased the risk for fracture among elderly women, especially vertebral fractures. Smoking cessation decreased the risk for vertebral fractures but not for other types of fractures.
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Affiliation(s)
- M H Thorin
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
| | - A Wihlborg
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
| | - K Åkesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Lund, Sweden
- Department of Orthopedics, Skåne University Hospital, 205 02, Malmö, Sweden
| | - P Gerdhem
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
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Ochi K, Furuya T, Ishibashi M, Watanabe M, Ikari K, Taniguchi A, Yamanaka H, Momohara S. Risk factors associated with the occurrence of proximal humerus fractures in patients with rheumatoid arthritis: a custom strategy for preventing proximal humerus fractures. Rheumatol Int 2015; 36:213-9. [DOI: 10.1007/s00296-015-3371-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/22/2015] [Indexed: 01/23/2023]
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Risk factors associated with the occurrence of distal radius fractures in Japanese patients with rheumatoid arthritis: a prospective observational cohort study. Clin Rheumatol 2013; 33:477-83. [DOI: 10.1007/s10067-013-2415-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/05/2013] [Accepted: 10/18/2013] [Indexed: 11/25/2022]
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Clement ND, McQueen MM, Court-Brown CM. Social deprivation influences the epidemiology and outcome of proximal humeral fractures in adults for a defined urban population of Scotland. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2013; 24:1039-46. [DOI: 10.1007/s00590-013-1301-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/17/2013] [Indexed: 11/28/2022]
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Abstract
Proximal humeral fractures are common, with low-energy injuries occurring in the elderly population and less frequent high-energy fractures striking young people. This article discusses the anatomy, clinical evaluation, and treatment of these fractures.
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Affiliation(s)
- David Rothberg
- Orthopaedic Traumatology, University of California at Davis, Sacramento, CA 95817, USA.
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Comparative study of T-plates and locking plates in the management of displaced proximal humeral fractures. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e31825a225a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
There is limited data regarding the epidemiology, pathology, and management of distal radius fractures from centers in Asia. The advanced economies in Asia include Hong Kong, Japan, Korea, Singapore, and Taiwan, whereas the prominent emerging economies are China, India, Malaysia, Philippines, and Thailand. This article examines the available epidemiological data from Asia, compares the management of distal radius fractures in the advanced and emerging Asian economies and how they compare with the current management in the west. It concludes by offering solutions for improving outcomes of distal radius fractures in Asia.
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Affiliation(s)
- Sandeep J. Sebastin
- Consultant, Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore
| | - Kevin C. Chung
- Professor of Surgery, Assistant Dean for Faculty Affairs, Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI, United States
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Hongo M, Miyakoshi N, Shimada Y, Sinaki M. Association of spinal curve deformity and back extensor strength in elderly women with osteoporosis in Japan and the United States. Osteoporos Int 2012; 23:1029-34. [PMID: 21455761 DOI: 10.1007/s00198-011-1624-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 02/24/2011] [Indexed: 11/25/2022]
Abstract
UNLABELLED The difference in the shape of sagittal spinal curvature and distribution of vertebral fractures in women of comparable age with osteoporosis from Japan and the United States with different cultures and lifestyles was identified. Back extensor strength was significantly associated with lumbar lordosis in Akita group, indicating the potential importance of strengthening the back extensor. INTRODUCTION The purpose of the study was to assess the association of osteoporotic spinal deformities with back strength in elderly women in Japan and the United States. METHODS Subjects diagnosed with osteoporosis were selected to participate prospectively. In both groups, we measured the angles of thoracic kyphosis and lumbar lordosis with plain lateral radiographs and back extensor strength. The number of vertebral fractures and the ratio of lumbar fractures to thoracic fractures are also evaluated. The level of participants' daily activities was assessed with use of comparable tests in Akita (quality-of-life score) and Minnesota (physical activity score). RESULTS A total of 102 Japanese women residing in Akita, Japan (Akita group), and 104 white women evaluated in Rochester, MN, USA (Minnesota group), participated in this study. The angle of thoracic kyphosis and lumbar lordosis was higher in the Minnesota group than in the Akita group. The ratio of lumbar fractures to thoracic fractures was higher in the Akita group than in the Minnesota group. In the Akita group, multiple regression analysis revealed that the angle of lumbar lordosis correlated significantly with back extensor strength. CONCLUSIONS We identified the difference in the shape of sagittal spinal curvature and distribution of vertebral fractures in women of comparable age with osteoporosis from two geographic areas of the world with different cultures and lifestyles. Back extensor strength was significantly associated with lumbar lordosis in Akita group, indicating the potential importance of strengthening the back extensor for improving or maintaining lumbar lordosis.
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Affiliation(s)
- M Hongo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 0108543, Japan.
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Orimo H, Nakamura T, Fukunaga M, Ohta H, Hosoi T, Uemura Y, Kuroda T, Miyakawa N, Ohashi Y, Shiraki M. Effects of alendronate plus alfacalcidol in osteoporosis patients with a high risk of fracture: the Japanese Osteoporosis Intervention Trial (JOINT) - 02. Curr Med Res Opin 2011; 27:1273-84. [PMID: 21554143 DOI: 10.1185/03007995.2011.580341] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The authors conducted a randomized controlled trial to clarify the efficacy and safety of alendronate plus alfacalcidol versus alendronate alone in a clinical setting. RESEARCH DESIGN AND METHODS Eligible patients were postmenopausal women with severe osteoporosis who were aged 70 years or older and had several risk factors for incident fractures. The primary endpoint was prevention of incident fractures, and the anti-fracture efficacy was evaluated in relation to the baseline serum 25(OH)D level. RESULTS A total of 2164 patients were randomized to alendronate plus alfacalcidol (combination therapy) or alendronate alone (monotherapy). Although the overall difference in the incidence of vertebral fracture between the two groups was not significant, the combination therapy group had a significantly reduced risk of vertebral fractures after the first 6 months (HR, 0.53). In subgroup analyses, the combination therapy group was superior in the strata of number of prevalent vertebral fractures of ≥2 (HR, 0.51) and grade 3 of prevalent vertebral fractures (HR, 0.55). The rate of non-vertebral weight-bearing bone fractures was significantly lower in the combination therapy group than in the monotherapy group during the follow-up period (HR, 0.31). A lower baseline 25(OH)D level was associated with a higher incidence of non-vertebral weight-bearing bone fractures (HR, 3.42) despite alendronate use. Although one patient given the combination therapy had mild hypercalcemia, serious hypercalcemia and unknown adverse events were not encountered. Because of the limitations presented in this study, these results may not apply to female patients with longer than 2 years of treatments, and to male osteoporosis patients. CONCLUSIONS The combination therapy was no more effective for overall vertebral fracture prevention. However, subgroup analysis has shown that it was more effective for fracture prevention in patients with severe vertebral deformity, multiple prevalent vertebral fractures, and for non-vertebral weight-bearing bone fracture prevention.
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Abstract
BACKGROUND To elucidate the characteristics of hip fractures and the current status of their treatment in Japan, the Japanese Orthopaedic Association (JOA) conducted a nationwide hip fracture survey from 1998 to the present. The aim of the current report was to present the changes in patient distribution by age and fracture type, cause of fracture, treatment selection, and duration of hospitalization for a study period of one decade. METHODS A tally of all hip fractures that occurred in patients between 2001 and 2008 was conducted in JOA-authorized hospitals and in Japanese Clinical Orthopaedic Association (JCOA) hospitals. Registration forms were sent to these hospitals each year, and registration was performed based on their hospital records. RESULTS The mean response rate was 51.8%, and the total number of patients aged ≥35 with new hip fractures between 2001 and 2008 was 402 760. A drastic increase in the number of patients, especially those aged ≥90 was observed over the course of the decade. More trochanteric fractures occurred than neck fractures during the observational period; however, the neck/trochanter ratio increased over time. Simple falls were the most common cause of fracture. About 94% patients were treated surgically with about a 5-day presurgical hospital stay, and the mean hospitalization period was 40.7 days in 2008. CONCLUSIONS This one-decade survey demonstrated a drastic increase in the number of patients over the course of the decade in Japan. Appropriate treatment and prevention of hip fractures, including the treatment of osteoporosis and more effective interventions for preventing falls, are important issues to address to reduce the burden of this fracture.
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Øyen J, Rohde GE, Hochberg M, Johnsen V, Haugeberg G. Low-energy distal radius fractures in middle-aged and elderly women-seasonal variations, prevalence of osteoporosis, and associates with fractures. Osteoporos Int 2010; 21:1247-55. [PMID: 19774323 DOI: 10.1007/s00198-009-1065-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Accepted: 08/31/2009] [Indexed: 01/07/2023]
Abstract
UNLABELLED There is a lack of data on the prevalence of osteoporosis in patients with distal radius fractures occurring at the various seasons. The prevalence of osteoporosis is high, both in patients with indoor and outdoor fractures and higher than in controls. All female distal radius fracture patients >or=50 years should be referred for osteoporosis assessment. INTRODUCTION The objectives of this study in female distal radius fracture patients were to investigate seasonal differences, estimate the prevalence of osteoporosis, and identify factors associated with distal radius fractures compared with controls. METHODS In a 2-year period, 263 women >/=50 years suffered a low-energy distal radius fracture in the geographic catchment area. The 214 women who met for osteoporosis assessment were age-matched with 191 controls. Bone mineral density was assessed by dual energy X-ray absorptiometry at femoral neck, total hip, and lumbar spine. Demographic and clinical data were collected. RESULTS The prevalence of indoor fractures showed no seasonal variance. For outdoor fractures, the prevalence was highest in the winter months. The prevalence of osteoporosis among patients with indoor fractures was higher (58.5%) than outdoor fractures without (38.6%) and with snow/ice (36.0%; p < 0.001). The prevalence of osteoporosis was higher in fracture patients (42.5%) than controls (24.1%; p < 0.001), this was also found in the youngest age group 50-59 years (22.2% vs 1.8%; p < 0.001). In conditional logistic regression analyses osteoporosis, current use of glucocorticoids, and living alone were independently associated with distal radius fractures. CONCLUSIONS Our study highlights that environmental factor, as well as osteoporosis are associated with distal radius fractures in middle-aged and elderly women. Osteoporosis is also frequently found in outdoor patients, thus, all female distal radius fracture patients >or=50 years should be referred for osteoporosis assessment.
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Affiliation(s)
- J Øyen
- Department of Surgical Sciences, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Sakai A, Oshige T, Zenke Y, Yamanaka Y, Otsuka H, Nakamura T. Shorter unipedal standing time and lower bone mineral density in women with distal radius fractures. Osteoporos Int 2010; 21:733-9. [PMID: 19543845 DOI: 10.1007/s00198-009-0992-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 06/01/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Unipedal standing time was shorter and bone mineral density was lower in Japanese women aged 50 years and over with low-energy distal radius fractures resulting from falls than those in age-matched community-dwelling Japanese women without distal radius fractures. INTRODUCTION The aim of this study was to compare unipedal standing time and bone mineral density (BMD) of women >or=50 years of age with distal radius fractures with those of age-matched women without fractures. METHODS Fracture group was 54 Japanese women with low-energy distal radius fractures resulting from fall. Non-fracture group was 52 community-dwelling Japanese women without fractures. Unipedal standing time and BMD were measured. RESULTS There were no significant differences in age and body mass index between the two groups. The percentage of women with unipedal standing time <15 s was 44.4% in the fracture group and 13.5% in the non-fracture group, while the respective frequencies for >120 s were 20.4% and 50.0%. The T-score of BMD was significantly lower in the fracture than non-fracture group. Logistic regression analysis identified unipedal standing time <15 s and T-score <70% as significant factors associated with distal radius fractures. Notably, T-score <70% was significant in subjects <65 years, and unipedal standing time <15 s was significant in those >or=65 years. CONCLUSION Unipedal standing time was shorter and BMD was lower in women >or=50 years of age with distal radius fractures than those in age-matched women without fractures.
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Affiliation(s)
- A Sakai
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan.
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Hagino H, Furukawa K, Fujiwara S, Okano T, Katagiri H, Yamamoto K, Teshima R. Recent trends in the incidence and lifetime risk of hip fracture in Tottori, Japan. Osteoporos Int 2009; 20:543-8. [PMID: 18633667 DOI: 10.1007/s00198-008-0685-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Accepted: 05/29/2008] [Indexed: 11/30/2022]
Abstract
SUMMARY Hip fracture incidence from 2004 to 2006 in the Tottori prefecture of Japan was investigated and compared with previously reported rates. The age- and gender-specific incidence of hip fracture in the Tottori prefecture has not plateaued, as has been reported for populations in Northern Europe or North America. INTRODUCTION Recent data from Northern Europe and North America indicate that the incidence of hip fracture has plateaued, whereas most reports from Asia indicate that the incidence is increasing. The aims of this study were to investigate the recent incidence of hip fracture in the Tottori prefecture, Japan, and to compare it with previous reports. METHODS All hip fractures in patients aged 35 years and older occurring between 2004 and 2006 were surveyed in all of the hospitals from the Tottori prefecture. The age- and gender-specific incidence rates were then calculated. Using these and previously reported data, the estimated number of hip fracture patients was determined using the age- and gender-specific incidence rates in each year from 1986 to 2006. RESULTS The survey identified 851, 906, and 1,059 patients aged 35 years and older, in 2004, 2005, and 2006 respectively. The residual lifetime risk of hip fracture for individuals at 50 years of age was estimated to be 5.6% for men and 20.0% for women. The estimated number of patients from 1986 to 2006 showed a significant increase over time for both genders. CONCLUSIONS The age- and gender-specific incidence of hip fracture in the Tottori prefecture, Japan has not plateaued for either gender.
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Affiliation(s)
- H Hagino
- Rehabilitation Division, Tottori University Hospital, Yonago, Japan.
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Clinton J, Franta A, Polissar NL, Neradilek B, Mounce D, Fink HA, Schousboe JT, Matsen FA. Proximal humeral fracture as a risk factor for subsequent hip fractures. J Bone Joint Surg Am 2009; 91:503-11. [PMID: 19255209 PMCID: PMC2669747 DOI: 10.2106/jbjs.g.01529] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND With the aging of the world's population, the social and economic implications of osteoporotic fractures are at epidemic proportions. This study was performed to test the hypothesis that a proximal humeral fracture is an independent risk factor for a subsequent hip fracture and that the risk of the subsequent hip fracture is highest within the first five years after the humeral fracture. METHODS A cohort of 8049 older white women with no history of a hip or humeral fracture who were enrolled in the Study of Osteoporotic Fractures was followed for a mean of 9.8 years. The risk of hip fracture after an incident humeral fracture was estimated with use of age-adjusted Cox proportional hazards regression analysis with time-varying variables; women without a humeral fracture were the reference group. Cox regression analysis was used to evaluate the timing between the proximal humeral and subsequent hip fracture. Risk factors were determined on the basis of a review of the current literature, and we chose the variables that were most predictive and easily ascertained in a clinical setting. RESULTS Three hundred and twenty-one women sustained a proximal humeral fracture, and forty-four of them sustained a subsequent hip fracture. After adjustment for age and bone mineral density, the hazard ratio for hip fracture for subjects with a proximal humeral fracture relative to those without a proximal humeral fracture was 1.83 (95% confidence interval = 1.32 to 2.53). After multivariate adjustment, this risk appeared attenuated but was still significant (hazard ratio = 1.57; 95% confidence interval = 1.12 to 2.19). The risk of a subsequent hip fracture after a proximal humeral fracture was highest within one year after the proximal humeral fracture, with a hazard ratio of 5.68 (95% confidence interval = 3.70 to 8.73). This association between humeral and hip fracture was not significant after the first year, with hazard ratios of 0.87 (95% confidence interval = 0.48 to 1.59) between one and five years after the humeral fracture and 0.58 (95% confidence interval = 0.22 to 1.56) after five years. CONCLUSIONS In this cohort of older white women, a proximal humeral fracture independently increased the risk of a subsequent hip fracture more than five times in the first year after the humeral fracture but was not associated with a significant increase in the hip fracture risk in subsequent years.
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Affiliation(s)
- Jeremiah Clinton
- Department of Orthopaedics, Box 356500, University of Washington Medical Center, 1959 N.E. Pacific Street, Seattle, WA 98195-6500. E-mail address for F.A. Matsen III:
| | - Amy Franta
- 875 South Waterville Lake Road, Oconomowoc, WI 53066
| | - Nayak L. Polissar
- The Mountain-Whisper-Light Statistical Consulting, 1827 23rd Avenue East, Seattle, WA 98112
| | - Blazej Neradilek
- The Mountain-Whisper-Light Statistical Consulting, 1827 23rd Avenue East, Seattle, WA 98112
| | - Doug Mounce
- Department of Orthopaedics, Box 356500, University of Washington Medical Center, 1959 N.E. Pacific Street, Seattle, WA 98195-6500. E-mail address for F.A. Matsen III:
| | - Howard A. Fink
- Geriatric Research Education and Clinical Center, VA Medical Center, 11-G, One Veterans Drive, Minneapolis, MN 55417
| | - John T. Schousboe
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416
| | - Frederick A. Matsen
- Department of Orthopaedics, Box 356500, University of Washington Medical Center, 1959 N.E. Pacific Street, Seattle, WA 98195-6500. E-mail address for F.A. Matsen III:
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Hagino H. Features of limb fractures: a review of epidemiology from a Japanese perspective. J Bone Miner Metab 2007; 25:261-5. [PMID: 17704990 DOI: 10.1007/s00774-007-0760-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 03/29/2007] [Indexed: 11/24/2022]
Affiliation(s)
- Hiroshi Hagino
- Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-machi, Yonago, Tottori 683-8504, Japan.
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Abstract
UNLABELLED We sought to determine current trends in the number of fall-related and osteoporosis-related proximal humeral fractures in elderly Finns during last three decades. We collected data from the National Hospital Discharge Register on all patients 60 years or older who were admitted to Finnish hospitals from 1970 to 2002 for primary treatment of proximal humeral fractures. Fractures induced by traffic accidents or other high-energy traumas were excluded. The number and incidence (per 100,000 patients) of fractures increased from 208 (number) and 32 (incidence) in 1970 to 1120 (number) and 105 (incidence) in 2002. The age adjusted incidence of proximal humeral fractures also showed an increase, from 51 (1970) to 129 (2002) in women, and from 14 (1970) to 48 (2002) in men. In women 80 years or older, the age specific incidence of fracture increased from 90 (1970) to 294 (2002), while in the other age groups trend changes were less extensive. The mean patient age also increased, from 73 years (1970) to 78 years (2002) in women and from 70 years (1970) to 73 years (2002) in men. If these trends continue, the number of fractures in elderly Finns will triple during the next three decades. LEVEL OF EVIDENCE Prognostic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Mika Palvanen
- Accident & Trauma Research Center, UKK Institute for Health Promotion Research, Tampere, Finland.
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Hagino H, Katagiri H, Okano T, Yamamoto K, Teshima R. Increasing incidence of hip fracture in Tottori Prefecture, Japan: trend from 1986 to 2001. Osteoporos Int 2005; 16:1963-8. [PMID: 16133645 DOI: 10.1007/s00198-005-1974-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Accepted: 06/12/2005] [Indexed: 10/25/2022]
Abstract
We conducted a survey of all hip fractures in patients 35 years old and over during 1998-2001 in Tottori Prefecture, Japan, and compared them with those reported previously. The survey found 604, 671, 710, 729 patients, in 1998, 1999, 2000, and 2001, respectively. The mean age- and gender-specific incidences (per 100,000 person-years) for men were 108.0, 209.0, 449.1, and 780.0 in the age groups of 70-74, 75-79, 80-84 and over 84, respectively, and those for women were 249.1, 505.8, 1,115.4, and 2,066.4, respectively. The expected numbers of patients in 1998 were 1.23 and 1.42 times those in 1986, and those in 2001 were 1.61 and 1.48 times those in 1986, for men and women, respectively, and the increases with time for both genders were significant. It was concluded that there was a significant increase in the incidence rates of hip fracture from 1986 to 2001.
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Affiliation(s)
- Hiroshi Hagino
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, 683-8504, Japan.
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Siqueira FV, Facchini LA, Hallal PC. The burden of fractures in Brazil: a population-based study. Bone 2005; 37:261-6. [PMID: 15921970 DOI: 10.1016/j.bone.2005.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2004] [Revised: 03/06/2005] [Accepted: 04/05/2005] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The elderly population is growing fast worldwide, and therefore, investigation of health outcomes peculiar to these individuals is a public health priority nowadays. The decade between 2000 and 2010 is denominated as the Bone and Joint Decade, and researchers are encouraged to quantity the burden of musculo-skeletal disorders worldwide. This is particularly relevant to developing countries, where the burden of these diseases is not well known. This study aims to evaluate the prevalence of fractures (lifetime and previous year) and its association with socio-demographic variables and medical diagnosis of osteoporosis. MATERIALS AND METHODS Population-based cross-sectional study including a multiple-stage sample of individuals aged 20 years or more living in Pelotas, a southern Brazilian city. Both the lifetime prevalence of fractures and the proportion of fractures in the year prior to the interview were investigated. Sex, age, skin color, socioeconomic level, schooling level and medical diagnosis of osteoporosis were used as independent variables. After descriptive and crude analyses, a Poisson regression was carried out in order to provide prevalence ratios including adjustment for confounding. RESULTS The lifetime prevalence of fractures was 28.3%, and 2.3% of the individuals broke a bone in the year prior to the interview. Among men, most fractures were caused by sports practice and happened in leisure-time outside home. Among women, most fractures occurred inside home and were caused by falls. The lifetime prevalence of fractures was positively associated with male sex and white or mixed skin color. The prevalence of fractures in the year prior to the interview was greater among poor individuals and those with a medical diagnosis of osteoporosis. Among all fractures happened in older adults (60 years or more) in the 12 months prior to the interview, 83.3% were caused by falls. CONCLUSIONS Data of this investigation might help policy makers to reduce the burden of fractures, particularly among women and older adults, by stimulating prevention against household falls and osteoporosis. Special attention should be given to the poorest individuals, who have a greater likelihood of developing several negative health outcomes and presented a higher risk of fractures in the present study.
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