ESPE Abstracts (2018) 89 P-P1-029

Fracture Epidemiology for Children in Western Australia between 2005-2015: Do We Need to be Concerned about Bone Health?

Mark Jenkinsa,b, Sophia Nimphiusa,b, Nicolas Harta,b,c, Paola Chiversb,c,d, Timo Rantalainenb,d,e,f, Kristina Rüterg,h, Meredith Borlandg,h, Fleur McIntyreb,i, Katherine Stannagej & Aris Siafarikasb,d,e,h,k,l

aCentre for Exercise and Sports Science Research, Edith Cowan University, Perth, WA, Australia; bWestern Australian Bone Research Collaboration, Perth, WA, Australia; cExercise Medicine Research Institute, Perth, WA, Australia; dInstitute for Health Research, University of Notre Dame Australia, Perth, WA, Australia; eExercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia; fGerontology Research Center, University of Jyväskylä, Jyväskylä, Finland; gEmergency Department, Princess Margaret Hospital, Perth, WA, Australia; hUniversity of Western Australia, Medical School, Division of Paediatrics, Perth, WA, Australia; iSchool of Health Sciences, University of Notre Dame Australia, Perth, WA, Australia; jDepartment of Orthopaedic Surgery, Princess Margaret Hospital, Perth, WA, Australia; kDepartment of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, WA, Australia; lTelethon Kids Institute for Child Health Research, Perth, WA, Australia

Aim: Western Australia is a state with unique geography and population distribution having only a single tertiary paediatric hospital (Princess Margaret Hospital, PMH in Perth) managing the majority of children and adolescents with fractures in the Emergency Department (ED). Fracture incidence in 0–16 year olds is known to be high and varies between countries with boys having a 1.5 fold higher fracture incidence than girls. There are no specific data for Australia. The aims of this study were to characterize presentations with upper and lower limb fractures to PMH-ED and compare trends in the incidence rate to population data.

Methods: This is a database audit of fracture presentations between 2005–2015 for fracture rates with a sub-analysis for gender, fracture site and age relative to Perth Metropolitan and Western Australian population data.

Results: The audit reported a total of 31,340 fracture presentations from 27,516 individual children (87.8%) with 3,036 children reporting two or more fractures (9.7%). Fracture incidence, adjusted for the annual population size, increased from 0.63% in 2005 to 0.85% in 2015 (P<0.001). The winter months had a higher incidence of fractures than the summer months. Males had a higher fracture incidence than females: 18,763 versus 12,577, ratio 1.5:1 (P<0.001), with upper limb fractures three times more common than lower limb fractures (P<0.001). Fracture incidence increased with age until the early teenage years when a decline occurred.

Conclusions: Increased fracture incidence in Western Australia between 2005 and 2015 identifies a concerning trend for bone health in children and adolescents. Further research is needed to identify potential lifestyle factors that impact fracture incidence in order to reverse increasing fracture incidencein childhood.