Estimating the global incidence of femur fracture

Background/Purpose: Trauma causes over five million deaths and many more disabilities annually, disproportionately affecting the young and the poor. Femur fractures occur in approximately one in ten road traffic (RT) injuries and can be effectively treated with surgery. Current incidence of femur fracture by country and by age group is unknown and difficult to measure directly, but is critical to designing and evaluating interventions. Methods: We modeled femur fracture incidence from RT collisions using World Bank, World Health Organization (WHO), and Global Burden of Disease (GBD) data for 176 countries. For all countries and age groups, we estimated femur fracture rate using RT death rates, ratios of RT deaths to injuries, and proportions of RT injuries that were femur fractures. Results: We estimated worldwide annual femur fracture incidence between 1.0 and 2.9 million. Most femur fractures occurred between ages 5 and 14 years (29%), 15 and 44 years (34%), and in those older than 60 (21%). Overall, low- and middle-income countries (LMICs) had an average femur fracture rate between 15.5 and 44.8 per 100,000 people, with an odds ratio of 1.90 (95% CI, 1.89–1.92; p <0.001) compared to high-income countries (HICs). Conclusions: Our estimates were comparable to worldwide and country-specific estimates from other publications. The results demonstrated significant worldwide burden and disparities in femur fracture incidence between LMICs and HICs, underscoring the impact of improved treatment access. This methodology can be applied to other diseases for estimation of burden, allowing for better direction of global health efforts.