Epidemiology of fracture is an essential part of epidemiological study, which consists of the incidence, proportion, risk factor analysis, and variation trend of fracture. As public requirements of health care develop, the precaution and management of fractures draw more attention. It’s conducive to knowing the characteristics and the variation of each fracture and analyze the related risk factors to conduct epidemiological investigation. A thorough clinical epidemiology of fracture can be the foundation of national medical and health management policy. This epidemiologic system is the guideline of precaution and treatment management of fractures for clinical practice. This chapter mainly aims to introduce the definition, classification, epidemiological characteristics, and risk factors of fractures. And we also aim to summarize the current epidemiological characteristics and the prevention strategy development of fracture in China to help formulate prevention strategy of fractures. We hope that our data could provide the basis for clinical treatment and precaution management ultimately of our country.

The aim of the study was to investigate the incidence of low-energy fracture of wrist, hip, and spine and the related risk factors in Chinese populations 50 years or older.This study was a part of the Chinese National Fracture Survey (CNFS) carried out in 8 Chinese provinces in 2015. Data on 154,099 Chinese men and women 50 years or older were extracted from the CNFS database for calculations and analyses. Low-energy fracture was defined as fracture caused by slip, trip, or falls from standing height.A total of 247 patients sustained low-energy fractures in 2014, indicating the incidence rate was 160.3/100,000 person-years, with 120.0 [95% confidence interval (CI), 95.5-144.5] and 213.1(95% CI, 180.7-245.6)/100,000 person-years in men and women, respectively. In men, advanced age, alcohol consumption, residence at second floor or above without elevator, sleep duration <7h/day, and history of past fracture were identified to be significant risk factors for low-energy fractures. In women, advanced age, living in east region, higher latitude zone (40 degrees N -49.9 degrees N), alcohol consumption, more births, sleep duration <7h/day, and history of past fracture were identified as significant risk factors. Supplementation of calcium or vitamin D or both was identified to be associated with reduced risk of fracture in women (odds ratio, 0.38; 95% CI, 0.20-0.75), but not in men.These epidemiologic data on low-energy fractures provided updated clinical evidence base for national healthcare planning and preventive efforts in China. Corresponding interventions such as decreasing alcohol consumption and sleep improvement should clearly be implemented. For women, especially those with more births and past history of fracture, routine screening of osteoporosis, and intensive nourishment since menopause should be advocated.

PurposeThis study aims to investigate the incidence of low-energy fractures in men aged 50 years and older in China and to explore associated risk factors.MethodsAll the relevant data were available from the China National Fracture Survey (CNFS), which was a cross-sectional survey carried out in eight Chinese provinces (municipalities) between January and May 2015.ResultsThrough 2014, 76,687 men above 50 years participated in this study and 223 participants had low-energy fractures, indicating the incidence rate 290.8 (95%CI, 252.7-328.9)/100,000 men. Over 80% of the fractures occurred at home and on the common road. The fracture incidence rate presented a significant rising trend with advanced age (p = 0.039). Current smoking, alcohol overconsumption, insufficient sleep duration, and history of past fracture were identified as significant risk factors associated with low-energy fracture (p < 0.05).ConclusionsThese results will assist the decisions regarding allocation of healthcare provision to populations of greatest need and aid the design and implementation of strategies to reduce fracture incidence. Accordingly, individuals should be encouraged to reduce alcohol consumption, immediately quit smoking, and get sufficient sleep, especially in those with a history of past fracture. In addition, primary preventives especially home prevention should be emphasized.