ESPE Abstracts (2016) 86 P-P1-104

Clinically Significant Fracture Incidence in Czech Children: A Population-based Study

Ondrej Soucek, Jan Lebl & Zdenek Sumnik


Department of Paediatrics, Charles University in Prague and Motol University Hospital, Prague, Czech Republic


Background: Before reaching adulthood, every second boy and every third girl will sustain a fracture. This growth spurt-related bone fragility is partially caused by a quick longitudinal growth and a relatively slower increase in bone width. However, no study has focused particularly on clinically significant fractures, a criterion for osteoporosis diagnostics.

Objective and hypotheses: The aim of this study was to describe the incidence of clinically significant fractures (i.e., extremity long bone and vertebral fractures) in healthy Czech population aged 0–20 years and thus establish a control data for comparison of fracture incidence in chronically ill children.

Method: The extremity long bone and vertebral fractures were recorded from the National Registry of Hospitalised Patients and the demographic data were obtained from the Institute of Health Information and Statistics of the Czech Republic. Number of fractures per age- and gender-specific population count was calculated. Data for years 2008–2014 were averaged.

Results: The median fracture incidence was 6.2‰ in boys and 2.4‰ in girls. Whereas there were two peaks of fracture incidence occurring at the ages of 6 (7.1‰) and 13 (9.7‰) years in boys, there was no clear peak but a plateau between the ages 6 and 11 years in girls, with a fracture incidence around 5.5‰. The fracture incidence was similar in the first 3 years of age between the sexes (0.4–2.0‰), but from the fourth year the incidence was consistently higher in boys and remained more than two times higher at the age of 20 years (3.2‰ vs 1.4‰, P<0.001).

Conclusion: The incidence of fractures important for osteoporosis diagnostics is higher in boys than in girls and increases until the mid-puberty in boys and early puberty in girls. The role of bone quality and physical behaviour on fracture incidence remains to be elucidated.

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