Tibial shaft fractures in Finland between 1997 and 2014

Abstract

Introduction: Tibial shaft fracture is common, accounting for 2% of all adult fractures. Large epidemiological follow ups are lacking and previous studies have shown great variation in incidence rates and trends. The aim of this population-based nationwide study was to analyze all tibial shaft fractures in Finland in 1997-2014 and to provide an update on current epidemiological data.

Patients and methods: Patient data was collected from the Finnish National Hospital Discharge Register (NHDR) from 1997 to 2014. The study covered the entire adult (18 years and older) population. The primary outcome was the annual number of hospitalization due to a fresh tibial shaft fracture.

Results: A total of 14,150 patients with a fresh tibial shaft fracture were identified during the 18-year study period. The total fracture incidence decreased from 27.3 per 100,000 person-years in 1997 to 13.5 per 100,000 person-years in 2014. In men, the incidence was 34.9 in 1997 vs. 15.6 in 2014, while in women the corresponding numbers were 20.2 in 1997 vs. 11.5 in 2014.

Conclusions: The incidence of tibial shaft fractures has markedly decreased in Finland between 1997 and 2014, mainly because of a declining trend in the incidence of fall-induced low-energy fractures. Reasons for this development are uncertain and therefore more comprehensive population-based epidemiological studies are needed to reveal the factual reasons behind the decrease.

Keywords: Epidemiology; Incidence; Mechanism of injury; Register study; Tibial shaft fracture.