The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK
Introduction
A fracture of the distal radius usually follows a fall onto the outstretched arm and is related to osteoporosis in postmenopausal women.11 These fractures are painful, frequently require closed and sometime open reduction and are associated with complications such as reflex sympathetic dystrophy.2 In one study, 20% of cases were hospitalised and up to half of cases lost some function permanently.4
In women, the incidence of distal radius fracture is reported to rise after the menopause reaching a plateau between 60 and 70 years.10 In men, with a four-fold lower incidence,10 there is a steady increase between 20 and 80 years. Previous studies have suggested that these fractures occur more frequently during the winter months with more occurring outdoors than hip fractures.11
A history of a fracture of the distal radius over the age of 25 years increases the risk of fractures at other sites by a factor of a least two.6., 15.
We are interested in fracture prevention in Dorset, a semi-rural county of approximately 700,000 people in the south of England. We have carried out a County wide, year long, prospective survey of distal radius fractures in patients over 25 years of age to determine the extent of the local problem and compare our statistics with published data.
Section snippets
Methods
Following Local Research Ethics Committee approval all accident and emergency departments in all hospitals in Dorset and surrounding areas were asked if they treated Dorset residents with forearm fractures. All such hospitals were included in the study. All patients over the age of 25 years attending the departments with a record of any forearm fracture during 1 year were identified from the hospital records within 4 weeks of their attendance. In Poole and Bournemouth Hospitals computerised
Results
Seven district and community hospitals with accident and emergency departments accepting forearm fracture patients permanently or temporarily resident in Dorset were identified.
One thousand six hundred and eighty-eight patients presented to those hospitals with a recorded diagnosis of forearm fracture during the 12 months study period (March 1996–February 1997). One hundred and thirty-three patients (11%) were not registered with a Dorset General Practitioner. Of these, nine patients were from
Discussion
Our study suggests that there is a continuous rise in the incidence of distal radius fractures with age in women over the age of 50 years and men over the age of 65 years in contrast to established findings of a plateau in incidence with age.
There have been two recent independent surveys in the UK that have also shown a steady rise in the incidence of distal radius fractures in women from a baseline of 10 per 10,000 per year at the age of 60 years to a peak of 120 per 10,000 per year at the age
Acknowledgements
We thank the consultants and staff of participating hospitals. Professor Peter Thomas of the Dorset Research and Development Support Unit gave statistical advice. The study was supported by a Research Grant from Dorset Health Authority and was supervised by the Scientific Committee of Osteoporosis Dorset (registered charity no. 1023507).
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