title: Declining incidence of fall-induced ankle fractures in elderly adults: Finnish statistics between 1970 and 2014.
abstract: BACKGROUND
  Fall-induced fractures of older adults are a major public health concern. However, nationwide information on recent fracture trends is sparse.
  
  
  METHODS
  We determined the trend in the number and incidence (per 100,000 persons) of fall-induced ankle fractures among older adults in Finland by taking into account all persons 60 years of age or older who were admitted to Finnish hospitals for primary treatment of such fracture in 1970-2014.
  
  
  RESULTS
  The number of fall-induced ankle fractures among 60-year-old or older Finnish persons increased steadily and sharply between 1970 (369 fractures) and 1997 (1668 fractures), but since then, the increase has slowed down (1835 fractures in 2014). The raw incidence of ankle fracture, showing a clear rise from 57 fractures per 100,000 persons in 1970 to 169 fractures in 1997, declined steadily between 1997 and 2014 (to 126 fractures in 2014). Observations on the age-adjusted fracture incidence were similar. During 1970-1997, the age-adjusted incidence of fall-induced ankle fracture clearly rose in both women and men, but thereafter, the incidence declined; in women, from 199 in 1997 to 158 in 2014, and in men, from 123 in 1997 to 80 in 2014.
  
  
  CONCLUSIONS
  The sharp rise in the incidence of fall-induced ankle fracture in Finnish older adults from early 1970s until late 1990s has been followed by a declining fracture rate. Despite this welcome development, the rapid aging of our population is likely to increase the absolute number of these fractures in the near future, and therefore, large-scale fracture-preventing intervention studies are urgently needed.
authors.affiliation: Injury and Osteoporosis Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland. pekka.kannus@uta.fi.|Department of Orthopedics and Trauma Surgery, Medical School, Tampere University Hospital, University of Tampere, 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: Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Parkkari
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
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries
keywords: Ankle fracture; Older people; Secular trends