International Orthopaedics

, Volume 43, Issue 3, pp 687–695 | Cite as

Socioeconomic factors and individual lifestyles influencing the incidence of patella fractures: a national population-based survey in China

  • Yanbin Zhu
  • Song Liu
  • Wei Chen
  • Lin Wang
  • Xiaolin Zhang
  • Yingze ZhangEmail author
Original Paper



We aimed to do a national survey on the population-based incidence of patella fractures and related risk factors fracture in China.


All the data on patella fractures were available from the China National Fracture Survey (CNFS) between January and May in 2015. And in the CNFS, all eligible household members were selected from 24 urban cities and 24 rural counties of eight provinces of China, with stratified random sampling and the probability proportional to size method used. Questionnaire was sent to every participant for data collection and quality control was accomplished by our research team members.


A total of 512,187 valid questionnaires were collected, and relevant data were abstracted. There were a total of 69 patients with 69 patella fractures that occurred in 2014, indicating that the incidence was 13.5 (95% CI, 10.3–16.7))/100,000 person-years. Slip, trip, or fall from standing height was the most common cause, leading to 69.6% (48/69) of patella factures, followed by traffic accidents (18.8%, 13/69). Home and road were the first two most common places, where 86.9% of the overall injuries occurred. Age of 45–64 and 65–74 years, alcohol consumption and previous history of fractures were identified as independent risk factors for patella fracture.


Specific public health policies focusing on decreasing alcohol consumption should be implemented. Individuals aged 45–64 and 65–74 should pay more attention to bone mass density and prevention of falls, especially those with previous history of fracture.


Patella fracture Epidemiology Risk factors Population-based Questionnaire survey 



We are grateful to Q Zhang and H Wang of the Department of Orthopedics and to X Zhang of the Department of Statistics and Epidemiology for their kind assistance.

Funding support

This study was supported by the Hebei Province Medical Science Special Major Projects Research Fund.

Author contributions

Yingze Zhang designed the study; Wei Chen and Lin Wang searched relevant studies; Xiaolin Zhang analyzed and interpreted the data; Yanbin Zhu and Song Liu wrote the manuscript; and Yingze Zhang approved the final version of the manuscript.

Compliance with ethical standards

Competing interests

The authors declare that they have no conflict of interest.

Supplementary material

264_2018_3985_MOESM1_ESM.xlsx (46.6 mb)
ESM 1 (XLSX 47711 kb)


  1. 1.
    Crawford AH (1976) Fractures about the knee in children. Orthop Clin N Am 7:639–656Google Scholar
  2. 2.
    George R (1935) Bilateral bipartite patellae. Br J Surg 22:555–560CrossRefGoogle Scholar
  3. 3.
    Zhang Y, Su Y, Hao J, Punsoni M (2012) Clinical epidemiology of orthopedic trauma. Thieme, StuttgartCrossRefGoogle Scholar
  4. 4.
    Boström Å (1972) Fracture of the patella: a study of 422 patellar fractures. Acta Orthop Scand Suppl 143:1–80CrossRefGoogle Scholar
  5. 5.
    Courtbrown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury-international Journal of the Care of the Injured 37:691CrossRefGoogle Scholar
  6. 6.
    Larsen P, Courtbrown CM, Vedel JO, Vistrup S, Elsoe R (2016) Incidence and epidemiology of patellar fractures. Orthopedics 39:1CrossRefGoogle Scholar
  7. 7.
    Court-Brown CM, Biant L, Bugler KE, Mcqueen MM (2014) Changing epidemiology of adult fractures in Scotland. Scott Med J 59:30–34CrossRefGoogle Scholar
  8. 8.
    Bengnér U, Johnell O, Redlund-Johnell I (1986) Increasing incidence of tibia condyle and patella fractures. Acta Orthop Scand 57:334–336CrossRefGoogle Scholar
  9. 9.
    Curtis EM, Van dVR, Moon RJ, Jp VDB, Geusens P, De VF, van Staa TP, Cooper C, Harvey NC (2016) Epidemiology of fractures in the United Kingdom 1988–2012: variation with age, sex, geography, ethnicity and socioeconomic status. Bone 87:19CrossRefGoogle Scholar
  10. 10.
    Pasco JA, Lane SE, Brennan-Olsen SL, Holloway KL, Timney EN, Bucki-Smith G, Morse AG, Dobbins AG, Williams LJ, Hyde NK (2015) The epidemiology of incident fracture from cradle to senescence. Calcif Tissue Int 97:568–576CrossRefGoogle Scholar
  11. 11.
    Ray JM, Hendrix J (1992) Incidence, mechanism of injury, and treatment of fractures of the patella in children. J Trauma 32:464–467CrossRefGoogle Scholar
  12. 12.
    Chen W, Lv H, Liu S, Liu B, Zhu Y, Chen X, Yang G, Liu L, Zhang T, Wang H (2017) National incidence of traumatic fractures in China: a retrospective survey of 512 187 individuals. Lancet Global Health 5:e807CrossRefGoogle Scholar
  13. 13.
    Zhu Y, Liu S, Zhang X, Chen W, Zhang Y (2017) Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study. Int Wound J 14:982–988Google Scholar
  14. 14.
    Scholes S, Panesar S, Shelton NJ, Francis RM, Mirza S, Mindell JS, Donaldson LJ (2014) Epidemiology of lifetime fracture prevalence in England: a population study of adults aged 55 years and over. Age Ageing 43:234–240CrossRefGoogle Scholar
  15. 15.
    Clark MK, Sowers MF, Dekordi F, Nichols S (2003) Bone mineral density and fractures among alcohol-dependent women in treatment and in recovery. Osteoporos Int 14:396–403CrossRefGoogle Scholar
  16. 16.
    Albrand G, Munoz F, Sornayrendu E, Duboeuf F, Delmas PD (2003) Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY study. Bone 32:78–85CrossRefGoogle Scholar
  17. 17.
    Williams FM, Cherkas LF, Spector TD, Macgregor AJ (2005) The effect of moderate alcohol consumption on bone mineral density: a study of female twins. Ann Rheum Dis 64:309–310CrossRefGoogle Scholar
  18. 18.
    Seeman E (2001) Effects of tobacco and alcohol use on bone [M]// Osteoporosis. Two-Volume Set 2001:771–794 Google Scholar
  19. 19.
    Kanis JA, Johansson H, Johnell O, Oden A, De LC, Eisman JA, Pols H, Tenenhouse A (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737CrossRefGoogle Scholar
  20. 20.
    Klotzbuecher CM, Ross PD, Landsman PB, Iii TAA, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res Off J Am Soc Bone Miner Res 15:721–739CrossRefGoogle Scholar
  21. 21.
    Kanis JA, Johnell O, Laet CD, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefGoogle Scholar
  22. 22.
    Huntjens KM, van Geel TA, van Helden S, van den Bergh J, Willems P, Winkens B, Geusens PP, Brink PR (2013) The role of the combination of bone and fall related risk factors on short-term subsequent fracture risk and mortality. BMC Musculoskelet Disord 14:121CrossRefGoogle Scholar
  23. 23.
    Gunnes M, Mellström D, Johnell O (1998) How well can a previous fracture indicate a new fracture? A questionnaire study of 29,802 postmenopausal women. Acta Orthop Scand 69:508–512CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Yanbin Zhu
    • 1
    • 2
  • Song Liu
    • 1
    • 2
  • Wei Chen
    • 1
    • 2
  • Lin Wang
    • 1
    • 2
  • Xiaolin Zhang
    • 3
  • Yingze Zhang
    • 1
    • 2
    • 4
    Email author
  1. 1.Department of Orthopaedic Surgerythe Third Hospital of Hebei Medical UniversityShijiazhuangPeople’s Republic of China
  2. 2.Key Laboratory of Biomechanics of Hebei ProvinceShijiazhuangPeople’s Republic of China
  3. 3.Department of Statistics and EpidemiologyHebei Medical UniversityShijiazhuangPeople’s Republic of China
  4. 4.Chinese Academy of EngineeringBeijingPeople’s Republic of China

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