Faculty Collaboration Database

Risk of Recurrent Fracture: A Population-Based Study. Pediatrics 2019 Aug;144(2)

Date

07/17/2019

Pubmed ID

31308257

DOI

10.1542/peds.2017-2552

Scopus ID

2-s2.0-85071055733 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVES: To determine if children who sustain a fracture in childhood had an increased rate of fracture later in childhood or early adulthood. The a priori null hypothesis was that children who sustained a fracture would not have an increased rate of future fractures compared with children who did not sustain a fracture when controlling for important covariates.

METHODS: This is a population-based retrospective cohort study using health care databases in Ontario. Approximately 2.5 million healthy children aged 0 to 15 years living in Ontario, Canada between April 1, 2003, and March 31, 2004, were included and followed for 7 years. The exposure was occurrence of any fracture during a 1-year baseline period. The main outcome was any fractures during a 7-year follow-up period.

RESULTS: A total of 43 154 children suffered a fracture during the baseline year (17.5 fractures per 1000 child years). Children with a baseline fracture had a 60% higher rate of fracture (incidence rate ratio: 1.60; 95% confidence interval: 1.46-1.75; P < .0001) during the follow-up period after adjustment for sex, rurality, history of previous fracture, and the occurrence of other injuries (head and soft-tissue).

CONCLUSIONS: The occurrence of a fracture during childhood was associated with an increased rate of future fractures compared with children who did not suffer a fracture. Attempting to improve childhood bone health by targeting children who present to a fracture clinic with multiple fracture risk factors may be a useful strategy for secondary prevention of fractures and may have beneficial effects on long-term bone health.

Author List

Escott BG, To T, Beaton DE, Howard AW

Author

Benjamin G. Escott MBBS Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Fractures, Bone
Humans
Infant
Infant, Newborn
Male
Ontario
Population Surveillance
Recurrence
Retrospective Studies
Risk Factors