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 016 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 20052015 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.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology