title: Incidence and characteristics of proximal femoral fractures in an Afro-Caribbean population.
abstract: BACKGROUND
  Although fractures of the proximal femur (FPF) are supposedly less frequent in Black populations (studies of incidence are rare) the life expectancy in Africa is low, which could partially explain this notion. There is only one retrospective study on the incidence of FPF in the islands of the Caribbean, thus we performed an incidence study in the insular, circumscribed, 90% Afro-Caribbean population of Martinique. The goals of this study were: (1) to estimate the incidence of FPF; (2) and to prospectively describe the main characteristics.
  
  
  OBJECTIVE
  The incidence of fractures of the proximal femur in Martinique is lower than in Western countries.
  
  
  METHODS
  The raw and standardized incidence ratio of FPF in relation to the world population was estimated based on data from the Medical Information System Program (Programme de médicalisation des systèmes d'information [PMSI]) for all of Martinique for a period of 4 years (January 1, 2010 to December 31, 2013). Characteristics were based on all patients over the age of 60 who presented to the Fort-de-France University Hospital (CHU) for a FPF between December 1, 2011 and April 31, 2012. Patients with light-skin phenotype, high-energy fractures and secondary fractures were excluded from the study.
  
  
  RESULTS
  The standardized incidence ratio in relation to the world population was estimated (n=794) as 22.5/100,000 patient-years [20.6-24.4]: 22.6 and 22.4/100,000 in men and women respectively. The characteristics of eighty-seven patients (including 56 women), mean age 85.3 (±7.2) (62-100) years old were evaluated: 52 femoral neck fractures (60%) and 33 fractures of the greater trochanter (38%). The 2-month mortality rate was 21%, and 1/3 of the surviving patients could function independently. The risk of death increased in relation to the initial risk of moderate to severe dementia.
  
  
  CONCLUSIONS
  The incidence of FPF in Martinique is lower than in Western countries and includes, as expected, an elderly, female population. Unlike a previous study performed in Guadeloupe, there was a majority of femoral neck fractures. A Caribbean multi-insular study is needed to confirm these results and to obtain precise data on bone density.
  
  
  METHODS
  IV; descriptive prospective epidemiological study.
authors.affiliation: Service de chirurgie orthopédique, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique. Electronic address: Jean-Louis.Rouvillain@chu-fortdefrance.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Rouvillain
authors.affiliation: Service de chirurgie orthopédique, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: F
authors.initials: F
authors.lastname: De Cazes
authors.affiliation: DRCI, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: R
authors.initials: R
authors.lastname: Banydeen
authors.affiliation: Service d'information médicale (DIM), CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: K
authors.initials: K
authors.lastname: Rome
authors.affiliation: Service de rhumatologie, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: P
authors.initials: P
authors.lastname: Numéric
authors.affiliation: Service de rhumatologie, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: M
authors.initials: M
authors.lastname: De Bandt
authors.affiliation: DRCI, CHU de Martinique, CS 90632, 97261 Fort-de-France, Martinique.
authors.forename: C
authors.initials: C
authors.lastname: Derancourt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology; D026684:Personal Autonomy; D011446:Prospective Studies
keywords: Afro-Caribbean population; Epidemiology; Fracture of the upper part of the femur; Geriatric trauma; Incidence