title: Continuous decline in incidence of distal humeral fracture of older women in Finland.
abstract: BACKGROUND
  Low-trauma fractures (also called osteoporotic fragility fractures or fall-induced fractures) of older adults are a serious public health problem. However, very little population-based information is available on the nationwide numbers, incidences, and especially secular trends of elderly people's low-trauma fractures of the distal humerus.
  
  
  METHODS
  We assessed the current trends in the number and incidence of these fractures in 60-year-old or older women in Finland by taking into account all women who were admitted to Finnish hospitals for primary treatment of such fracture in 1970-2014.
  
  
  RESULTS
  The annual number of low-trauma distal humeral fractures among Finnish women 60 years of age or older rose over fivefold between 1970 and 1998 (from 42 to 224 fractures), but thereafter, the number decreased down to 198 fractures in 2014. The age-adjusted incidence (per 100,000 persons) of these fractures also increased in 1970-1998 (from 12 to 35) but decreased thereafter to 23 in 2014. The finding was similar in the age-specific patient groups (60-69, 70-79, and 80+): The incidence rose from 1970 till 1998 and decreased thereafter.
  
  
  CONCLUSIONS
  The steep rise in the rate of low-trauma distal humeral fractures in 60-year-old or older Finnish women from 1970 till late 1990s has been followed by a clearly declining fracture rate. The exact reasons for this secular change are unknown, but a cohort effect toward improved functional ability among elderly women, as well as measures to prevent falls and alleviate fall severity, could partly explain the phenomenon.
authors.affiliation: Injury and Osteoporosis Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland. pekka.kannus@uta.fi.|Medical School, University of Tampere, Tampere, Finland. pekka.kannus@uta.fi.|Department of Orthopedics and Trauma Surgery, Tampere University Hospital, Tampere, Finland. pekka.kannus@uta.fi.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kannus
authors.affiliation: Injury and Osteoporosis Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Niemi
authors.affiliation: Injury and Osteoporosis Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
authors.affiliation: Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Parkkari
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006810:Humeral Fractures / Q000453:epidemiology*; D015994:Incidence; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D000092464:Elbow Injuries
keywords: Distal humeral fracture; Epidemiology; Falling; Older women; Secular trends