Epidemiology of osteoporotic ankle fractures in elderly persons in Finland

Background: Although osteoporotic or minimal trauma fractures among elderly persons are a major public health problem worldwide, epidemiologic information on these fractures is limited. Objective: To determine the current trend in the number and incidence of osteoporotic ankle fractures in the elderly. A fracture was defined as osteoporotic only if it occurred as a result of minimal trauma in a person 60 years of age or older. Design: National hospital discharge register. Setting: Finland, a country with approximately 5 million inhabitants. Participants: All patients 60 years of age or older who were admitted to hospitals in Finland for primary treatment of first osteoporotic ankle fracture in 1970 to 1972, 1974, 1975, 1978 to 1980, 1983 to 1985, 1988 to 1989, and 1991 to 1994. Measurements: The number and the age-specific and age-adjusted incidence of osteoporotic ankle fractures in each year of the study. Results: For the study period, the number and incidence (per 100 000 persons) of osteoporosis-related ankle fractures in Finnish persons 60 years of age or older increased considerably (370 and 57, respectively, in 1970 compared with 1243 and 130, respectively, in 1994). The age-adjusted incidence of these fractures also increased in women, from 66 in 1970 to 162 in 1994, and in men, from 38 in 1970 to 82 in 1994. Conclusion: The number of osteoporotic ankle fractures in Finland is increasing at a rate that cannot be explained simply by demographic changes. Vigorous preventive measures are needed to control the increasing burden of this type of fracture.