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Children who experience their first fracture at a young age have high rates of fracture

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Abstract

Rate of fracture was examined according to age at first fracture in 313 New Zealand children (145 girls, 168 boys) under l3 years of age (95.4% of a consecutive series of children treated at one hospital for a recent confirmed fracture at any site). In their lifetimes they had experienced 468 separate fracture events, over half (54.7%) occurring in the 32.3% of children breaking bones on more than one occasion. Children experiencing a first fracture before 4 years of age had 36.7 (95%CI 30.7–44.1) fractures per l00 years of exposure: this was a significantly higher rate than that of children experiencing their first fracture later in life. Thus, using the <4.0 year age group as a reference, we found that rate ratios (adjusted for gender) for groups that had suffered the first fracture at later ages were: first fracture between 4.0 and 6.99 years, 0.77 (95%CI 0.58–1.03); first fracture between 7.0 and 9.99 years, 0.63 (95%CI 0.42–0.94); first fracture between 10.0 and 12.99 years, 0.48 (95% CI 0.32–0.72). Asthma was over-represented (31% seen, 25% expected), and a high proportion of the sample (32.9%) used corticosteroid medications; however, neither characteristic affected age at first fracture. In contrast, the large number (n= 42) of youngsters (13.4% of the sample) reporting adverse reactions to milk were younger at first fracture than children without reactions to milk (P<0.05). We conclude that children experiencing their first fracture at a young age have high rates of fracture and should be targeted for advice to improve their bone strength.

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Acknowledgments

We thank all the children and parents who participated and are especially grateful to the staff of the Departments of Orthopaedics, Radiology, Pediatrics and Emergency Care for their willing co-operation in this study. We acknowledge grant support from the Bone Research Unit, University of Otago and ACC. F-J.Y. was the recipient of an Otago BMed Sci (Hons) Scholarship. This study was funded and supported by the Accident Compensation Corporation (ACC), Wellington, New Zealand. Views and/or conclusions in this article are those of the authors and may not reflect the position of ACC.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Otago, P.O. Box 913, Dunedin, New Zealand

    F-J. Yeh, A. M. Grant & A. Goulding

  2. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand

    S. M. Williams

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  1. F-J. Yeh
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  2. A. M. Grant
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  3. S. M. Williams
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  4. A. Goulding
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Correspondence to A. Goulding.

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Yeh, FJ., Grant, A.M., Williams, S.M. et al. Children who experience their first fracture at a young age have high rates of fracture. Osteoporos Int 17, 267–272 (2006). https://doi.org/10.1007/s00198-005-2009-y

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  • DOI: https://doi.org/10.1007/s00198-005-2009-y

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