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Summary <p>Pediatric fracture epidemiology in Asian countries is limited. Using a nationwide claims database (2018–2024), we demonstrated lower fracture incidence in Thai vs. Western children. Incidence was higher in males and adolescents. Incidence fell during COVID-19 then rebounded, resulting in non-significant overall change. Forearm fractures and traffic injuries were prominent.</p> Purpose <p>Data on pediatric fracture epidemiology in Thailand remain limited. We aimed to examine 7-year trends in fracture incidence among Thai children and adolescents.</p> Methods <p>Fractures recorded in the National Health Security Office (NHSO) claims database from 2018 to 2024 were identified using ICD-10 codes. Fracture incidence in individuals aged &lt; 20&#xa0;years was calculated per 10,000 person-years among NHSO-insured population. Temporal trends were summarized using annual percent change (APC).</p> Results <p>We identified 787,866 fractures among 569,819 individuals. The median annual age-standardized incidence rate (ASIR) was 88.1 per 10,000 person-years (range, 76.5–90.6), with a median (Q1–Q3) male-to-female incidence rate ratio (IRR) of 2.6 (2.5–2.6). Forearm fractures were the most common (31%). Incidence increased gradually with age in females but rose sharply in males, with the greatest sex difference during adolescence (IRR, 3.35 [95% CI: 3.32–3.38]). Transportation injuries (37%) and falls (35%) were the leading causes of fractures. ASIR declined during 2018–2022 (APC −4.2%/year, 95% CI: −6.5% to −2.0%) and increased during 2022–2024 (APC 9.6%/year, 95% CI: 4.5%–14.9%), resulting in an overall stable trend (average APC 0.15%/year, 95% CI: −1.27%–1.59%).</p> Conclusions <p>Fracture incidence among&#xa0;the Thai pediatric population was lower than that reported from Western countries and remained relatively constant during 2018–2024. Incidence was highest in male adolescents, with traffic accident being the major contributor. Strengthening targeted prevention, particularly traffic–safety interventions, should be a national priority to reduce pediatric fracture burden in Thailand.</p>

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Temporal trend of pediatric fracture epidemiology in Thailand: a nationwide study 2018–2024

  • 期刊论文

  • 发表日期：

    2026年4月21日

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  • Nattakarn Numsriskulrat,
  • Chatchai Suesirisawad,
  • Ratikorn Chaisiwamongkol,
  • Putthapong Ponpitak,
  • Ouyporn Panamonta,
  • Kaewjai Thepsuthammarat,
  • Pattara Wiromrat

摘要

Summary

Pediatric fracture epidemiology in Asian countries is limited. Using a nationwide claims database (2018–2024), we demonstrated lower fracture incidence in Thai vs. Western children. Incidence was higher in males and adolescents. Incidence fell during COVID-19 then rebounded, resulting in non-significant overall change. Forearm fractures and traffic injuries were prominent.

Purpose

Data on pediatric fracture epidemiology in Thailand remain limited. We aimed to examine 7-year trends in fracture incidence among Thai children and adolescents.

Methods

Fractures recorded in the National Health Security Office (NHSO) claims database from 2018 to 2024 were identified using ICD-10 codes. Fracture incidence in individuals aged < 20 years was calculated per 10,000 person-years among NHSO-insured population. Temporal trends were summarized using annual percent change (APC).

Results

We identified 787,866 fractures among 569,819 individuals. The median annual age-standardized incidence rate (ASIR) was 88.1 per 10,000 person-years (range, 76.5–90.6), with a median (Q1–Q3) male-to-female incidence rate ratio (IRR) of 2.6 (2.5–2.6). Forearm fractures were the most common (31%). Incidence increased gradually with age in females but rose sharply in males, with the greatest sex difference during adolescence (IRR, 3.35 [95% CI: 3.32–3.38]). Transportation injuries (37%) and falls (35%) were the leading causes of fractures. ASIR declined during 2018–2022 (APC −4.2%/year, 95% CI: −6.5% to −2.0%) and increased during 2022–2024 (APC 9.6%/year, 95% CI: 4.5%–14.9%), resulting in an overall stable trend (average APC 0.15%/year, 95% CI: −1.27%–1.59%).

Conclusions

Fracture incidence among the Thai pediatric population was lower than that reported from Western countries and remained relatively constant during 2018–2024. Incidence was highest in male adolescents, with traffic accident being the major contributor. Strengthening targeted prevention, particularly traffic–safety interventions, should be a national priority to reduce pediatric fracture burden in Thailand.