INTRODUCTION:Insight in epidemiologic data of extremity fractures is relevant to identify people at risk. By analyzing age- and gender specific fracture incidence and treatment patterns we may adjust future policy, take preventive measures and optimize health care management. Current epidemiologic data on extremity fractures and their treatment are scarce, outdated or aiming at a small spectrum of fractures. The aim of this study was to assess trends in incidence and treatment of extremity fractures between 2004 and 2012 in relation to gender and age. METHODS:We used a combination of national registries of patients aged ≥ 16 years with extremity fractures. Fractures were coded by the International Classification of Diseases (ICD) 10, and allocated to an anatomic region. ICD-10 codes were used for combining the data of the registries. Absolute numbers, incidences, number of patients treated in university hospitals and surgically treated patients were reported. A binary logistic regression was used to calculate trends during the study period. RESULTS:From 2004 to 2012 the Dutch population aged ≥16 years grew from 13,047,018 to 13,639,412 inhabitants, particularly in the higher age groups of 46 years and older. The absolute number of extremity fractures increased significantly from 129,188 to 176,129 (OR 1.308 [1.299-1.318]), except for forearm and lower leg fractures. Incidences increased significantly (3-4%) for wrist, hand/finger, hip/upper leg, ankle and foot/toe fractures. In contrast to the older age categories from 66 years and older, in younger age categories from 16 to 35 years, fractures of the extremities were more frequent in men than in women. Treatments gradually moved towards non-university hospitals for all except forearm fractures. Both relative and absolute numbers increased for surgical treatments of clavicle/shoulder, forearm, wrist and hand/finger fractures. Contrarily, lower extremity fractures showed an increase in non-surgical treatment, except for lower leg fractures. CONCLUSION:During the study period, we observed an increasing incidence of extremity fractures and a shift towards surgical treatment. Patient numbers in university hospitals declined. If these trends continue, policy makers would be well advised to consider the changing demands in extremity fracture treatment and pro-actively increase capacity and resources.

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简介:对四肢骨折的流行病学数据的了解与识别高危人群有关。通过分析特定年龄和性别的骨折发生率和治疗方式,我们可以调整未来的政策,采取预防措施并优化医疗保健管理。目前关于四肢骨折及其治疗的流行病学数据很少,已经过时或针对的是一小部分骨折。这项研究的目的是评估2004年至2012年间肢体骨折的发病率和治疗趋势与性别和年龄的关系。
方法:我们对年龄≥16岁的四肢骨折患者进行了国家注册。骨折由国际疾病分类(ICD)10编码,并分配到解剖区域。 ICD-10代码用于合并注册表数据。报告了绝对数量,发病率,在大学医院中接受治疗的患者和通过手术治疗过的患者的数量。在研究期间,使用二元逻辑回归来计算趋势。
结果:从2004年到2012年,年龄在16岁以上的荷兰人口从13047018增至13639412,特别是在46岁及以上的较高年龄段。除前臂和小腿骨折外,四肢骨折的绝对数量从129,188个显着增加至176,129个(OR 1.308 [1.299-1.318])。手腕,手/手指,臀部/大腿,脚踝和脚/脚趾骨折的发生率显着增加(3-4%)。与66岁及以上的老年人相比,在16至35岁的年轻人中,男性上肢骨折的发生率高于女性。除前臂骨折外,其他所有患者的治疗方法都逐渐转向非大学医院。锁骨/肩膀,前臂,腕部和手/手指骨折的手术治疗的相对和绝对数量均增加。相反,下肢骨折除小腿骨折外,非手术治疗有所增加。
结论:在研究期间,我们观察到四肢骨折的发生率增加,并且转向外科治疗。大学医院的患者人数有所下降。如果这些趋势继续下去,将建议政策制定者考虑对四肢骨折治疗不断变化的需求,并积极增加能力和资源。

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