Acta Orthopaedica - 2026-03-25 - Journal Article
National rates of pediatric extremity fractures over a 20-year timespan in Denmark: a population-based descriptive cohort study.
Lund AR, Færgemann C, Gundtoft P, Viberg B
Topics
Key Takeaway
The overall incidence rate of pediatric extremity fractures in Denmark was 3,164 per 100,000 persons/year over 20 years, with forearm fractures most common and upper/lower leg fractures the only anatomical sites showing a declining trend.
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Summary
Using the Danish National Patient Registry (ICD-10 codes), this study characterized incidence rates (IRs) and anatomical distribution of all extremity fractures in children aged 0–15 years across Denmark from 1999–2018. The overall IR was 3,164 per 100,000 persons/year, with forearm fractures carrying the highest proportion; IR increased with age and was consistently higher in boys. The overall IR rose across the study period, with the sole exceptions being upper and lower leg fractures, which declined.
Key Limitation
ICD-10 administrative coding lacks fracture-specific detail (displacement, Gartland/Jakob classification, treatment rendered), making it impossible to assess whether rising incidence translates to increased operative demand or complication rates.
Original Abstract
BACKGROUND AND PURPOSE
Previous reports on incidences rates of Scandinavian pediatric extremity fractures have varied, as they are often anatomically specific and based on institution-specific findings. To gain knowledge of current and future burden on the healthcare system, a national cohort assessment is necessary. We aimed to assess the proportion and incidence within anatomical distributions of pediatric extremity fractures in relation to age, sex, and time trends.
METHODS
We retrieved a 20-year population-based cohort from the Danish National Patient Registry 1999-2018. We included all children aged 0-15 years with an extremity fracture diagnosis (ICD-10). We estimated fracture proportions and incidence rates (IRs) in different anatomical regions stratified by sex, age groups, and periods. IRs were estimated based on national population counts.
RESULTS
We included 668,595 pediatric fractures corresponding to an overall IR of 3,164 (95% confidence interval 3,157-3,172) per 100,000 persons/year. The highest proportion and IR were in the lower arm, but the proportions differed within the age groups. The IR increased with age and was higher in boys. The overall IR increased during the study period. In upper and lower leg fractures a decrease was seen, with all other anatomical sites increasing.
CONCLUSION
We found an increased IR during the study period for all fractures except for the upper and lower leg. The study gives important knowledge to the healthcare system when coordinating the right resources.