The Norwegian incidence rates of distal forearm fractures are the highest ever reported.
The purpose of this study was to investigate possible urban-rural gradients in self-reported forearm fractures, and assess the contribution of lifestyle and socio-demographic factors to such gradients. The very large population-based collaborative Norwegian study Cohort Norway (CONOR) offered the opportunity to examine these issues. All the participants underwent a standardized examination and answered common questions on socio-demographic conditions, risk factors and diseases, including one question concerning former forearm/wrist fractures. Based on the home-addresses, participants were divided into three population density groups cities, densely and sparsely populated areas. The analyses are limited to the participants 30 years and above with valid information on place of residence, of whom 14.5 % reported a forearm fracture.
The prevalence increased with increasing degree of urbanization for both genders. After adjustment for age and potential explanatory factors, the odds ratio of having sustained a forearm fracture was significantly increased in men living in densely populated areas and in cities compared to rural areas, with an evident urbanization gradient not explained by other factors. Similar results were observed among women. Although not among the fractures with the most serious consequences for the individual, distal forearm fracture is nevertheless an indicator of postmenopausal osteoporosis. Almost 50% of women and about 30% of men 50 years or older with a low energy wrist fracture have osteoporosis, and wrist fractures are an important predictor of suffering a subsequent osteoporotic fracture.