Comparison of fracture patterns between rural and urban populations in a developing country

The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment.

This was a retrospective multicentre study involving two urban and three rural hospitals in Malaysia. The demographic data and anatomical location of fracture of patients admitted in 2007 were collected for analysis.

A total of 7,973 patients were admitted for fractures between January and December 2007. The femur was the commonest fracture site that required admission in the urban population (21.9 percent), followed by the tibia-fibula (18.7 percent), while the radius-ulna was the commonest site among the rural population (22.0 percent), followed by the tibia-fibula (19.4 percent). The rates of head and pelvic fractures were comparatively higher in the urban population, while hand fractures were more common in the rural population. The higher rate of femur fracture in the urban group, especially among the elderly, may be due to the higher incidence of osteoporosis or a higher proportion of older people in the population.

The anatomical locations of common fractures differed between the urban and rural populations. A higher rate of upper limb fractures was observed in the rural areas, while femur fractures in the elderly was the main cause of fracture admission in the urban areas. The relatively high rate of hand fractures in the rural areas, especially among children and young adults, may require further investigation.