Background: The purpose of this study was to determine the annual
incidence rates of non-work-related traumatic fractures and dislocations
(excluding head and facial injuries) referred for orthopaedic services in a
large population enrolled under a capitated insurance contract.
Methods: The number of fractures and dislocations that were referred
for orthopaedic services were recorded prospectively from among an average of
135,333 persons per year who were enrolled under a capitated insurance
contract during the three-year study period. These data were used to determine
the gender-specific and age-specific incidence rates of fractures and
dislocations referred for orthopaedic services.
Results: A total of 3440 fractures and 422 dislocations were
referred for orthopaedic services during the three-year study period. The
incidence rate of fractures referred for orthopaedic services was 8.47 per
1000 member-years, with a significantly (p < 0.0001) higher rate among
males. Members between the ages of ten and fourteen years had the highest rate
of fractures referred for orthopaedic services (21.52 per 1000 member-years).
The lifetime risk of a traumatic fracture referred for orthopaedic services to
the age of sixty-five years was one in two for both males and females. The
incidence rate of dislocations referred for orthopaedic services was 1.04 per
1000 member-years, which did not differ significantly (p = 0.75) between
genders. Members between the ages of fifteen and nineteen years had the
highest rate of dislocations referred for orthopaedic services (2.75 per 1000
member-years). The lifetime risk of a traumatic dislocation referred for
orthopaedic services to the age of sixty-five years was one in sixteen for
both male and female members.
Conclusions: Young males had the highest rate of traumatic fractures
referred for orthopaedic services. Adolescents of both genders had high rates
of traumatic dislocations referred for orthopaedic services. The lifetime risk
of a non-work-related fracture referred for orthopaedic services to the age of
sixty-five years is approximately equal to that of coronary artery
disease.
Level of Evidence: Prognostic study, Level II-1
(retrospective study). See Instructions to Authors for a complete description
of levels of evidence.