Oral Presentation ANZBMS-MEPSA-ANZORS 2022

Fractures lead to increased morbidity and mortality in the elderly, but they are a musculoskeletal issue that occurs at all ages. Fracture rates are often estimated based on hospitalisation data, which only gives a complete picture for certain fracture types. In New Zealand, injuries are covered by a no-fault national insurance system known as ACC. Most fractures that require clinical attention are recorded as ACC claims. The aim of this study was to determine the frequency of fractures in New Zealand overall and at key sites in different genders and ethnic groups across the lifespan.

Individualised fracture claim data were obtained from ACC for 2010-2019. 945,041 fracture claims were included in the analysis. Prioritised ethnicity was reported (order of priority: Māori, Pacific peoples, Asian/Other, European) for 98% of claims. Census data was used to calculate fracture incidence. A setting where the injury occurred was reported in 91% of claims.

Males accounted for 52.7% of fractures in the entire dataset, however over the age of 50, fracture incidence is 70% higher in women (Table). Europeans had the highest incidence overall, and Māori and Pacific people have lower incidence of fractures than Europeans in all age groups in women and all but 20-39 years of age in men. Asian people had the lowest incidence of fracture in young adults, but similar rates to Europeans in the elderly. Hip fractures mainly occur in the elderly and show lower incidence in Māori and Pacific people than Europeans (Table). Almost half of all fractures occurred at home, rising to over 80% in the elderly. 30% of fractures in people aged 10-39 occurred in a place of recreation/sports.

Age, gender and ethnicity all affect fracture incidence, with peaks in adolescents and the elderly. Māori and Pacific people, particularly women, generally have lower fracture rates than Europeans.