Global burden, trends and forecast analysis of extremity fractures based on GBD 2021

Abstract

Background: A quite common kind of clinical trauma, extremity fractures (EFs) have a significant impact on patients and society. Thus, the global burden of disease (GBD) trend for EFs was analyzed for the first time in this study using the GBD 2021 database, which serves as a crucial foundation for the creation of future prevention and treatment strategies and aids in the sensible distribution of health care resources. Methods: We retrieved incidence, prevalence, and years lived with disabilities (YLDs) for seven EFs by area, age, and sex from the GBD 2021 database for 1990-2021. Based on the sociodemographic index (SDI), we evaluated the burden of EFs and forecasted its trend over the ensuing two decades. Estimated annual percentage change (EAPC) and 95% confidence interval (CI) were employed to evaluate burden trends over time. Results: Fracture of patella, tibia or fibula, or ankle had the greatest age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized YLDs (ASYR) in 2021, with respective rates of 439.7/100,000, 3811.1/100,000, and 196.6/100,000. The burdens of EFs exhibit a declining trend from 1990 to 2021, with fracture of foot bones except ankle showing the most noticeable decrease, with EAPCs of-1.12,-1.12, and-1.14 for ASIR, ASPR, and ASYR, respectively. Absolute health disparities between high and low SDI nations exist and growing, with low SDI countries continuing to bear the majority of the illness burden in EFs. The distribution of the burden of these seven EFs varied by gender and age. Furthermore, during the next 20 years, there will be a notable global reduction in the burden of EFs. Conclusions: The global burden of EFs has been recognized as a major public health challenge. Cross-regional standardized diagnostic and treatment frameworks, the development of effective prevention and treatment strategies, and the rational allocation of resources are essential for reducing the burden of EFs.