BACKGROUND: Individuals who sustain a low-energy @entity174 are at increased risk of sustaining a subsequent low-energy @entity174 . The incidence of these refractures may be reduced by secondary preventative measures, although justifying such interventions and evaluating their impact is difficult without substantive evidence of the severity of the refracture risk. The aim of this study was to quantify the risk of sustaining another @entity174 following a low-energy @entity174 compared with the risk in an age and sex-matched reference population. METHODS: During the twelve-year period between January 1988 and December 1999, all inpatient and outpatient @entity174 -treatment events were prospectively audited in a trauma unit that is the sole source of @entity174 treatment for a well-defined local catchment population. During this time, 22,060 @entity1 at least forty-five years of age who had sustained a total of 22,494 low-energy @entity174 of the hip, wrist, proximal part of the humerus, or ankle were identified. All refracture events were linked to the index @entity174 in the database during the twelve-year period. The incidence of refracture in the cohort of @entity1 who had sustained a previous @entity174 was divided by the "background" incidence of index @entity174 within the same local population to obtain the relative risk of refracture. @entity1 -years at-risk methodology was used to control for the effect of the expected increase in mortality with advancing age. RESULTS: Within the cohort, 2913 @entity1 (13.2%) subsequently sustained a total of 3024 refractures during the twelve-year period. @entity1 with a previous low-energy @entity174 had a relative risk of 3.89 of sustaining a subsequent low-energy @entity174 . The relative risk was significantly increased for both sexes, but it was greater for @entity1 (relative risk = 5.55) than it was for @entity1 (relative risk = 2.94). The relative risk was 5.23 in the youngest age cohort ( @entity1 between forty-five and forty-nine years of age), and it decreased with increasing age to 1.20 in the oldest cohort ( @entity1 at least eighty-five years of age). CONCLUSIONS: Individuals who sustain a low-energy @entity174 between the ages of forty-five and eighty-four years have an increased relative risk of sustaining another low-energy @entity174 . This increased risk was greater when the index @entity174 occurred earlier in life; the risk decreased with advancing age. Secondary preventative measures designed to reduce the risk of refracture following a low-energy @entity174 are likely to have a greater impact on younger individuals.

Refractures in XXXX at least forty-five years old. a prospective analysis of twenty-two thousand and sixty @entity1 .

@entity1 :: ('9606', 'Species') :: ['Person', 'women', 'Patients', 'patients', 'men'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture']
@entity1 :: (9606,Species) :: ['patients']
