Population-based prospective study on the incidence of osteoporosis-associated fractures in a German population of 200 413 inhabitants

A limited body of data is available with regard to the incidence of osteoporotic fractures in Germany. Most of the data published thus far have been derived from hospital records or health insurance settlements. The aim of the present study was to prospectively register four types of fractures in an urban population. The data we obtained were compared with the results of retrospective analysis procedures in order to determine the differences and underlying errors. An urban population of 200 413 residents was investigated prospectively with regard to osteoporosis-associated fractures over a period of 12 months. All fractures were recorded and confirmed on radiographs. The results of this analysis were compared with the data from the Statistical Bureau and the International Classification of Disease (ICD) registers of the hospitals. A total of 979 fractures occurred during the period of investigation. The most common type was the distal radius fracture (395; 197.1 per 100 000). The retrospective detected data of the Statistical Bureau were 31, 56 lower than the actual number of fractures. A retrospective analysis of fractures based on the ICD registers of the hospitals revealed an over-registration rate of 26.67. Retrospective methods of fracture registration do not provide sufficiently reliable data.