Forecasting fractures: Weather-associated variability in hip fracture and isolated distal radius fracture incidence

Low-energy hip fractures (HFs) and distal radius fractures (DRFs) are common orthopedic injuries. Although winter increases same-level, low-energy fall rates, the role of specific weather variables, and whether these effects differ by age or fracture type, remains unclear.

To evaluate weekly association between weather conditions and HF and DRF incidence over eight-years using age-stratified statistical models.

Retrospective review of 1882 HF and 444 DRF patients presenting to a single Level 1 trauma center from January 2017-March 2025. Daily local weather data were merged with injury dates and aggregated into weekly counts. Separate negative binomial regression models were run by fracture type and age group to evaluate associations between weekly mean temperature, relative humidity, rainy days, snow days, and near-freezing days and fracture incidence.

Weather-fracture relationships varied by age and fracture type. For HFs, rain days correlated with higher incidence in older and geriatric adults, while snow days were strongest in younger adults. For DRFs, rain and snow days increased incidence in both age groups, especially < 65 years. Higher relative humidity was protective in the oldest DRF cohort. Temperature showed a weak association with increased DRF incidence in younger adults and decreased HF incidence in younger adults.

Specific meteorologic conditions, not just seasons, were meaningfully associated with fracture incidence, with effects differing by age and fracture type. Age-stratified weather models may improve orthopedic preparedness, resource allocation, and fall-prevention strategies. As climate change increases precipitation variability and freeze-thaw cycles, weather-fracture associations become important for planning and prevention.