title: Fracture prevalence during an unusual period of snow and ice in the Netherlands.
abstract: BACKGROUND
  The objective of the current study was to assess the effect of an unusual 10-day snow and ice period on the prevalence of fractures in an emergency department (ED) in the Netherlands. Furthermore, patients with fractures during the snow and ice period were compared to those in the control period with respect to gender, age, location of accident, length of stay, disposition, and anatomical site of the injury.
  
  
  METHODS
  Fracture prevalence during a 10-day study period with snow and ice (January 14, 2013 until January 23, 2013) was compared to a similar 10-day control period without snow or ice (January 16, 2012 until January 25, 2012). The records of all patients with a fracture were manually selected. Besides this, basic demographics, type of fracture, and location of the accident (inside or outside) were compared.
  
  
  RESULTS
  A total of 1,785 patients visited the ED during the study period and 1,974 during the control period. A fracture was found in 224 patients during the study period and in 109 patients during the control period (P <0.01). More fractures sustained outside account for this difference. No differences were found in gender, mean age, and length of ED stay. However, during the snow and ice period the percentage of fractures in the middle-aged (31-60 yrs) was significantly higher than in the control period (P <0.01).
  
  
  CONCLUSIONS
  The number of fractures sustained more than doubled during a period with snow and ice as compared to the control period. In contrast to other studies outside the Netherlands, not the elderly, but the middle-aged were most affected by the slippery conditions.
authors.affiliation: Emergency Department, Medical Centre Haaglanden, P.O. box 432, 2501 CK The Hague, The Netherlands.
authors.forename: Crispijn L
authors.initials: CL
authors.lastname: van den Brand
authors.affiliation: Emergency Department, Medical Centre Haaglanden, P.O. box 432, 2501 CK The Hague, The Netherlands.
authors.forename: M Christien
authors.initials: MC
authors.lastname: van der Linden
authors.affiliation: Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: Naomi
authors.initials: N
authors.lastname: van der Linden
authors.affiliation: Department of Trauma Surgery, Medical Centre Haaglanden, P.O. box 432, 2501 CK The Hague, The Netherlands.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Rhemrev
keywords: Emergency medicine; Fractures; Prevention; Weather