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Rising Incidence of Low-Trauma Fractures of the Calcaneus and Foot Among Finnish Older Adults

¹ Injury & Osteoporosis Research Center, UKK Institute for Health Promotion Research, Finland.
² Medical School, University of Tampere, and Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Finland.
³ Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Finland.

Address correspondence to Professor Pekka Kannus, MD, PhD, UKK Institute, P.O. Box 30, FIN-33501 Tampere, Finland. E-mail: pekka.kannus{at}uta.fi

Background. Although various low-trauma fractures among older adults are said to be a major public health concern in contemporary societies with aging populations, reliable epidemiologic information on their secular trends is scarce.

Methods. We assessed the current trend in the number and incidence (per 100,000 persons) of low-trauma fractures of the calcaneus and foot of older adults in Finland, a European Union country with a well-defined white population of 5.2 million, by taking into account all persons 50 years old or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970–2005.

Results. The number and raw incidence of low-trauma fractures of the calcaneus and foot among Finns 50 years old or older rose considerably between the years 1970 and 2005, from 64 (number) and 5.6 (incidence) in 1970 to 294 and 15.2 in 2005. For the study period, the age-adjusted incidence of fracture was higher in men than women and showed a clear increase in both sexes in 1970–2005, from 7.3 to 17.4 in men (138% increase), and from 4.3 to 12.5 in women (191% increase). A similar finding was observed in the age-specific incidences. Assuming that the observed increase in the age-specific fracture incidence continues in the 50-year-old or older group and the size of this population increases as predicted, the annual number of low-trauma fractures of the calcaneus and foot in this population will be two times higher in the year 2030 (approximately 550 fractures annually) than it was during 2001–2005.

Conclusions. In Finnish persons aged 50 years or older, the number of low-trauma fractures of the calcaneus and foot has risen considerably in 1970–2005 with a rate that cannot be explained merely by demographic changes. Further studies are needed to explore the exact reasons for the rise and possibilities for fracture prevention.

Key Words: Calcaneus and foot • Elderly adults • Epidemiology • Falls • Low-trauma fractures • Secular trends