title: Children who experience their first fracture at a young age have high rates of fracture.
abstract: Rate of fracture was examined according to age at first fracture in 313 New Zealand children (145 girls, 168 boys) under l3 years of age (95.4% of a consecutive series of children treated at one hospital for a recent confirmed fracture at any site). In their lifetimes they had experienced 468 separate fracture events, over half (54.7%) occurring in the 32.3% of children breaking bones on more than one occasion. Children experiencing a first fracture before 4 years of age had 36.7 (95%CI 30.7-44.1) fractures per l00 years of exposure: this was a significantly higher rate than that of children experiencing their first fracture later in life. Thus, using the <4.0 year age group as a reference, we found that rate ratios (adjusted for gender) for groups that had suffered the first fracture at later ages were: first fracture between 4.0 and 6.99 years, 0.77 (95%CI 0.58-1.03); first fracture between 7.0 and 9.99 years, 0.63 (95%CI 0.42-0.94); first fracture between 10.0 and 12.99 years, 0.48 (95% CI 0.32-0.72). Asthma was over-represented (31% seen, 25% expected), and a high proportion of the sample (32.9%) used corticosteroid medications; however, neither characteristic affected age at first fracture. In contrast, the large number (n= 42) of youngsters (13.4% of the sample) reporting adverse reactions to milk were younger at first fracture than children without reactions to milk (P<0.05). We conclude that children experiencing their first fracture at a young age have high rates of fracture and should be targeted for advice to improve their bone strength.
authors.affiliation: Department of Medical and Surgical Sciences, University of Otago, P.O. Box 913, Dunedin, New Zealand.
authors.forename: F-J
authors.initials: FJ
authors.lastname: Yeh
authors.forename: A M
authors.initials: AM
authors.lastname: Grant
authors.forename: S M
authors.initials: SM
authors.lastname: Williams
authors.forename: A
authors.initials: A
authors.lastname: Goulding
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D017677:Age Distribution; D000367:Age Factors; D001134:Arm Injuries / Q000150:complications / Q000453:epidemiology; D001249:Asthma / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007223:Infant; D007869:Leg Injuries / Q000150:complications / Q000453:epidemiology; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications / Q000453:epidemiology; D009104:Multiple Trauma / Q000150:complications / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D012008:Recurrence; D017678:Sex Distribution
chemical_list: D000305:Adrenal Cortex Hormones