@article{ref1,
title="Risk of recurrent fracture: a population-based study",
journal="Pediatrics",
year="2019",
author="Escott, Benjamin G. and To, Teresa and Beaton, Dorcas E. and Howard, Andrew W.",
volume="144",
number="2",
pages="ePub-ePub",
abstract="OBJECTIVES: To determine if children who sustain a fracture in childhood had an increased rate of fracture later in childhood or early adulthood. The a priori null hypothesis was that children who sustained a fracture would not have an increased rate of future fractures compared with children who did not sustain a fracture when controlling for important covariates. <br><br>METHODS: This is a population-based retrospective cohort study using health care databases in Ontario. Approximately 2.5 million healthy children aged 0 to 15 years living in Ontario, Canada between April 1, 2003, and March 31, 2004, were included and followed for 7 years. The exposure was occurrence of any fracture during a 1-year baseline period. The main outcome was any fractures during a 7-year follow-up period. <br><br>RESULTS: A total of 43 154 children suffered a fracture during the baseline year (17.5 fractures per 1000 child years). Children with a baseline fracture had a 60% higher rate of fracture (incidence rate ratio: 1.60; 95% confidence interval: 1.46-1.75; <i>P</i> <.0001) during the follow-up period after adjustment for sex, rurality, history of previous fracture, and the occurrence of other injuries (head and soft-tissue). <br><br>CONCLUSIONS: The occurrence of a fracture during childhood was associated with an increased rate of future fractures compared with children who did not suffer a fracture. Attempting to improve childhood bone health by targeting children who present to a fracture clinic with multiple fracture risk factors may be a useful strategy for secondary prevention of fractures and may have beneficial effects on long-term bone health.<br><br>Copyright © 2019 by the American Academy of Pediatrics.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2017-2552",
url="http://dx.doi.org/10.1542/peds.2017-2552"
}