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Fracture incidence rates in Norwegian children, The Tromsø Study, Fit Futures

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Abstract

Summary

This study describes childhood fracture rates in Norway, a country known for high fracture rates in the adult population. Fracture rates correspond with other reports from Scandinavia, although with a slightly higher proportion in girls. Indications of increased vulnerability during stages of puberty require further exploration.

Introduction

Fractures are common injuries during childhood. Incidence rates and patterns vary, but population-based data are scarce. The aim of this study was to describe the sex-, age- and maturation-specific incidence of fractures in a representative population-based sample from a region in Norway.

Methods

All fractures in the population based convenient cohort Fit Futures, comprising 961 adolescents under 18 years, were recorded retrospectively from the local hospital. Details on individual’s age and fracture site were recorded. A radiologist confirmed all fractures.

Results

In the period from birth to cohort scanning, the register recorded 316 fractures in 253 individuals. Fractures were more common in boys (35%) than in girls (31%). The overall annual fracture incidence was 204 per 10,000 persons-year under the age of 18 and 205 under the age of 16. The majority of fractures involved the upper extremities and the most common site of fracture was the forearm with 24% of the fractures followed by phalanges with 23% of the fractures. Fractures peaked in girls at sexual maturation stage 3. Boys had a peak in stage 2. Timing of subsequent fractures was also consistent with stages of sexual maturation.

Conclusions

The overall incidence of fractures in childhood in Northern Norway corresponds with other reports from Scandinavia, although the proportion of fractures in girls is higher than in other studies. Both sexes seem especially vulnerable at stages related to sexual maturation. Whether this reflects bone vulnerability or other changes related to puberty requires further investigation.

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Acknowledgements

We are grateful to the study participants, the staff at the Clinical Research Unit at University Hospital of North Norway (UNN HF), and the Fit Futures administration for conducting the study. We thank Robert Kechter at Finnmark Hospital Trust and The Garvan Institute of Medical Research for office and administration contribution. We also thank The Norwegian Osteoporosis Association for supporting pediatric software and the Northern Norway Regional Health Authorities for funding this work.

Authors contribution

Study design: TC, AW, LAA, and NE. Study conduct: A-SF, GG, and NE. Data collection: TC, A-SF, GG, NE, OAN, and AW. Data analysis: TC, JAE, JRC, LAA, and NE. Data interpretation: TC, JAE, JRC, LAA, and NE. Drafting manuscript: TC, JAE, JRC, LAA, and NE. Revising manuscript content: TC, JAE, JRC, AW, LAA, GG, OAN, ED, and NE. Approving final version of manuscript: TC, JAE, JRC, AW, LAA, GG, OAN, ED, and NE. TC, LAA, and NE take responsibility for the integrity of the data analysis.

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Authors and Affiliations

  1. Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway

    Tore Christoffersen, Luai A. Ahmed, Anne Winther, Ole Andreas Nilsen & Nina Emaus

  2. Finnmark Hospital Trust, Alta, Norway

    Tore Christoffersen

  3. Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE

    Luai A. Ahmed

  4. Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway

    Anne Winther

  5. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Anne-Sofie Furberg

  6. Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

    Guri Grimnes

  7. Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Guri Grimnes

  8. MRC Lifecourse Epidemiology Unit, Southampton, UK

    Elaine Dennison

  9. Victoria University, Wellington, New Zealand

    Elaine Dennison

  10. Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia

    Jacqueline R. Center & John A. Eisman

  11. School of Medicine Sydney, The University of Notre Dame Australia, Fremantle, Australia

    John A. Eisman

  12. St. Vincent’s Clinical School, UNSW, Sydney, Australia

    Jacqueline R. Center & John A. Eisman

  13. Department of Endocrinology, St. Vincent’s Hospital, Sydney, Australia

    Jacqueline R. Center & John A. Eisman

Authors
  1. Tore Christoffersen
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  2. Luai A. Ahmed
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  3. Anne Winther
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  4. Ole Andreas Nilsen
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  5. Anne-Sofie Furberg
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  6. Guri Grimnes
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  7. Elaine Dennison
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  8. Jacqueline R. Center
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  9. John A. Eisman
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  10. Nina Emaus
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Corresponding author

Correspondence to Tore Christoffersen.

Ethics declarations

The study was approved by The Norwegian Data Protection Authority (reference number 2009/1282) and by The Regional Committee of Medical and Health Research Ethics (reference number 2011/1702/REKnord).

Conflict of interest

None.

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Christoffersen, T., Ahmed, L.A., Winther, A. et al. Fracture incidence rates in Norwegian children, The Tromsø Study, Fit Futures. Arch Osteoporos 11, 40 (2016). https://doi.org/10.1007/s11657-016-0294-z

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  • DOI: https://doi.org/10.1007/s11657-016-0294-z

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