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The epidemiology of osteoporotic fractures in a Mediterranean country

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Abstract

A population study was carried out over a period of 3 years (1987–1989) to determine the incidence of osteoporotic fractures. Fractures diagnosed in the two acute hospitals of the Maltese Islands were collected and classified according to the fracture site, age, sex, and patient's residence. Fractures in the Maltese Islands can only be diagnosed and adequately treated in these two general hospitals. A total of 8780 fractures were examined. Fracture of the neck of the femur was the most common fracture for which patients were admitted to the hospital. There were twice (1.96) as many females as males hospitalized for this fracture, giving an annual incidence of 262/100,000 females to 134/100,000 males over the age of 45. The fracture incidence was 2–3 times less than that found in North European countries, but was similar to the fracture rates obtained in Mediterranean studies. Fracture radius was the most frequent fracture treated on an outpatients basis. In over 45-year-olds, the female predominance persisted, giving a ratio of 3.65:1. This gave an annual incidence of 452/100,000 females to 150/100,000 males. Again, the fracture indicence obtained was significantly lower than that of Northern European countries. Other long bones showed a similar female to male (F:M) ratio in the cohort over 45 years of age. The bones showing this F:M ratio were the humerus (3.9:1), fibula (1.89:1), and tibia (1.6:1). Below 45 years of age males had more fractures than females for any bone studied. The epidimiological graphs obtained were similar to those of other studies suggesting that similar factors influence the development of osteoporosis. Further studies are required to analyze these factors in detail.

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References

  1. Winner SJ, Morgan CA, Evans JG (1989) Perimenopausal risk of falling and incidence of distal forearm fractures. BMJ 298: 1486–1488

    Google Scholar 

  2. Diez A, Puig J, Martinez MT, Diez JL, Aubria J, Vivancos J (1989) Epidemiology of fracture of the neck of femur associated with osteoporosis in Barcelona, Spain. Calcif Tissue Int 44:389–392

    Google Scholar 

  3. Matkovic V, Kosted K, Simonovic V, Buzina Z, Brodenek A, Nordin B (1989) Bone status and fracture ratio in two regions of Yugoslavia. Am J Clin Nut 32:540–549

    Google Scholar 

  4. Kanis JA (1990) The epidemiology of hip fracture in Europe. The MEDOS study (on behalf of the MEDOS Study Group). In: Christiansen et al (eds) Osteoporosis. Proc Copenhagen Int Symp Osteoporosis. Copenhangen, Denmark, pp 42–47

  5. Schmalholz A (1988) Epidemiology of distal radius fracture in Stockholm 1981–1982. Acta Orthop Scand 59:201–203

    Google Scholar 

  6. Albright F, Smith PH, Richardson AH (1941) Postmenopausal osteoporosis: its clinical features. JAMA 116:2465–2475

    Google Scholar 

  7. Williams R (1985) The influence of sex in disease. Churchill Livingstone, New York, pp 37–39

    Google Scholar 

  8. Demographic review of the Maltese Islands (1988) The Central Office of Statistics 1:1–2

  9. Annual statistical review Central Office of Statistics (1987) The Central Office of Statistics 1:1–2

  10. Vella G, Borg R (1989) Changes in fluoride levels in Maltese tap water. Maltese Med J 5:18–22

    Google Scholar 

  11. Levine S, Meckin M, Mercze J, Robin G, Neer E, Steinberg R (1970) Incidence of fracture of the proximal end of the femur in Jerusalem. A study of ethnic factors, Jerusalem, Israel. J Bone Joint Surg 52A:1193–1202

    Google Scholar 

  12. Genant HK, Boyd D (1977) Quantitative bone mineral analysis using energy computed tomography. Invest Radiol 12:545–551

    Google Scholar 

  13. Nilas L, Christiansen L, Robro P (1984) Oral calcium without effect on postmenopausal bone loss in osteoporosis. In: Christiansen C et al (eds) Osteoporosis. Aalborg, Stiftsbogtrykkeri, pp 639–642

  14. Kanders B, Lindsay R, Dempster D, Markand L, Voliquete G (1984) Determinants in bone mass in young healthy women. In: Christiansen C et al (eds) Osteoporosis. Aalborg, Stiftsbogtrykkeri, pp 337–340

  15. Weiss WS, Ure CL, Ballar JH (1980) Decreased risk of fractures of hip and lower forearm with postmenopausal use of oestrogen. N Engl Med J 303:1195–1198

    Google Scholar 

  16. Monteye HJ, Smith FL, Farden DF, Howel YJ (1980) Bone mineral in senior tennis players. Scan Sports Med 2:26–32

    Google Scholar 

  17. Solgaard S, Peterson VS (1985) Epidemiology of distal radius fractures. Acta Orthop Scand 56(5):391–393

    Google Scholar 

  18. Falch JA, Ilebekk A, Scangaard U (1985) Epidemiology of hip fractures in Norway. Acta Orthop Scand 54:681–686

    Google Scholar 

  19. Frandsen PA, Krause T (1983) Hip fractures in the county of Funen, Denmark. Acta Orthop 54:681–686

    Google Scholar 

  20. Hedlund R, Ahlbom A, Lindgren U (1985) Hip fracture incidence in Stockholm (1971–1981). Acta Orthop Scand 57:30–34

    Google Scholar 

  21. Boyce WJ, Vessey MP (1985) Rising incidence of fracture of the proximal femur. Lancet 1:150–151

    Google Scholar 

  22. Gallagher JC, Melton LJ, Riggs BL, Bergstrat E (1980) Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Rel Res 150:163–171

    Google Scholar 

  23. Lutse P (1990) Incidence of hip fractures in Finland. A forecast for 1990. Acta Orthop Scand 56:223–225

    Google Scholar 

  24. Alffram PA, Bauer GCH (1962) Epidemiology of fracture of the forearm. J Bone Joint Surg (Am) 44:105–114

    Google Scholar 

  25. Bengner U, Johnell O (1985) Increasing incidence of forearm fractures. A comparison of epidemiologic patterns 25 years apart. Acta Orthop Scand 56(2):158–160

    Google Scholar 

  26. Melton LJ III, Kane SH, Frye MA, Wahner HW, O'Falcon WM, Riggs BC (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 127:100–1011

    Google Scholar 

  27. Silverman SC, Madison RE (1988) Decreased incidence of hip fractures in Hispanics, Asians and blacks. California Hospital discharge data. Am J Public Health 78(11):1492

    Google Scholar 

  28. Bauer RC (1988) Ethnic differences in hip fractures. A reduced incidence in Mexican Americans. Am J Epidemiol 127(1):1456–1459

    Google Scholar 

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Baron, Y.M., Brincat, M., Galea, R. et al. The epidemiology of osteoporotic fractures in a Mediterranean country. Calcif Tissue Int 54, 365–369 (1994). https://doi.org/10.1007/BF00305520

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