Related Experiment Videos
Epidemiology of childhood fractures in Israel during 2000-2019
Galia Zacay1, Gal Dubnov-Raz2, Dalit Modan-Moses3
1Meuhedet Health Services, Tel Aviv, Israel; Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
Insights
Pediatric fracture rates in Israel varied by age, sex, and ethnicity over 20 years. Upper limb fractures were most common, with incidence declining in the general Jewish population but increasing in the ultra-Orthodox community.
Area of Science:
- Pediatric Orthopedics
- Epidemiology
- Public Health
Background:
- Reported international variations in pediatric fracture incidence rates.
- Need for localized data on pediatric fracture trends.
Purpose of the Study:
- To evaluate the incidence and characteristics of fractures in Israeli children over a 20-year period.
- To analyze trends in pediatric fractures based on demographic and seasonal factors.
Main Methods:
- Utilized electronic health records from Meuhedet Health Services (Israel) for 2000-2019.
- Extracted demographic and clinical data for all fractures in individuals under 18.
- Analyzed fracture data by age, sex, season, and population sector (general Jewish, ultra-Orthodox Jewish, Arab).
Main Results:
- Recorded 188,283 fractures in 142,049 individuals; upper limb fractures were most common (65%).
- Overall fracture rate was 251 per 10,000 person-years, higher in boys than girls.
- Significant decrease in fracture rates among general Jewish children; increase among ultra-Orthodox children; no significant change in Arab children.
- Fracture rates peaked in pre-adolescent girls and early adolescent boys, with seasonal peaks in spring and autumn.
Conclusions:
- Pediatric fracture incidence is influenced by age, gender, ethnicity, and season.
- Understanding these characteristics is crucial for developing targeted prevention strategies for pediatric fractures.
Background:
Differences have been reported in incidence rates of fractures in the pediatric population, between countries and over time. The aim of this study was to evaluate the incidence and characteristics of fractures over 20 years among Israeli children.
Methods:
Incidence rates of fractures were derived from the electronic database of Meuhedet Health Services, a health maintenance organization providing healthcare services to 1.2 million people in Israel. Demographic and clinical data were extracted of all the fractures in individuals aged <18 years during 2000-2019. Fracture sites were determined according to ICD9 definitions. Fracture data were analyzed by age, sex, season and sector (general Jewish population, ultra-orthodox Jews and Arabs).
Results:
During the study period 188,283 fractures occurred in 142,049 individuals. The most common were fractures of the upper limb (65%), followed by fractures of the lower limb [20%]. The overall fracture rate was 251 per 10,000 person- years (PY), and was higher for boys than girls (319 vs. 180 per 10,000 PY, p < 0.001). During 20 years, standardized fracture rates decreased significantly in the general Jewish population, among both boys (from 457 to 325 per 10,000 PY, p < 0.001) and girls (from 244 to 196 per 10,000 PY, p < 0.001); increased among ultra-orthodox Jewish boys (from 249 to 285 per 10,000 PY, p = 0.002) and girls (from 147 to 194 per 10,000 PY, p < 0.001); and did not change significantly among Arab boys and girls. The fracture rate peaked among girls aged 10-11 years and among boys aged 12-13 years. Seasonal variation showed a bimodal distribution with peaks during spring and autumn.
Conclusions:
The incidence of pediatric fractures is affected by age, gender, sector and season. Recognition of fracture characteristics may help identify specific populations and conditions for targeted prevention strategies.