50% of Americans Will Fracture a Bone

One out of every two Americans will fracture a bone and receive treatment from an orthopaedic surgeon before reaching their 65th birthday, according to a study presented at the 70th Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans.

The study followed more than 135,000 working adults and their dependents for three years and counted the number of fractures that required orthopaedic treatment, which included surgery, casting, and bracing.

The study found that the risk of sustaining a fracture up to age 65 was several times higher than the risk of stroke, breast cancer, prostate cancer, or adult-onset diabetes, and is approximately equal to the lifetime risk of coronary artery disease. The study's results predict that a fracture requiring orthopaedic services occurs about every 14 seconds in the United States.

Mark R. Brinker, MD, lead author of the study and Director of Acute and Reconstructive Trauma at Fondren Orthopedic Group L.L.P. and Texas Orthopedic Hospital in Houston, Texas, said the results show that fractures are a major public health concern.

In particular, children aged 10 to 14 years had very high fracture rates. The study showed that each year, approximately 1 in 37 boys and 1 in 62 girls 10 to 14 years of age will require orthopaedic services for a fractured bone. These rates are similar to the fracture rates reported in previous studies for persons over age 65 years.

Fracture rates from birth to 65 years of age were found to be about 30% higher on average among males, but in the subgroup of persons over age 45 years the risk of fracture is higher in women than in men. Other researchers have also observed this trend, which is usually attributed to the prevalence of osteoporosis among women as they age.

Nearly half of the fractures observed in the study required surgery and hospital care. According to the American Academy of Orthopaedic Surgeons, more than $10 billion a year is spent on hospital care associated with fracture treatment in the United States, and approximately $1 billion a year is spent on the associated office visits to physicians. In addition, the costs associated with days missed from work and lost wages while recovering from fractures are estimated to exceed $2.8 billion per year.

The authors stated that their study can be used to help predict future orthopaedic health care needs.

"As the American population becomes older in the coming years, the number of fractures per year and the need for fracture treatment is likely to increase substantially," said Daniel P. O'Connor, Ph.D., the study's coauthor. "The number of orthopaedic surgeons may also need to increase in order to continue to provide effective fracture care."

"Predicting future health care needs is an important issue when examining methods to control health care costs," Brinker added. "Accurately estimating the types of health care services that groups of people will require can be used to plan cost-efficient methods of providing those services while maintaining a high quality of care."

The 26,047-member American Academy of Orthopaedic Surgeons (www.aaos.org) or (http://orthoinfo.aaos.org ), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (http://www.usbjd.org ), the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives. The Academy's Annual Meeting is being held February 5-9, 2003, at the Ernest N. Morial Convention Center in New Orleans.