Association between Childhood Fracture and Subsequent Fracture Risk during Later Childhood and Early Adulthood: A Population-based Cohort Study

Background: Childhood fractures are common and may reflect underlying skeletal vulnerability.Whether a fracture in childhood predicts future fracture risk remains insufficiently explored using population-based data.Aim: To examine the association between childhood fracture and subsequent fracture risk during later childhood and early adulthood.Methodology: A population-based retrospective cohort study was conducted among 90 children (<16 years), equally divided into those with and without a baseline fracture.Participants were followed retrospectively for subsequent fractures.Incidence rates were calculated, and Poisson regression was used to estimate adjusted incidence rate ratios (IRRs).Fracture-free survival was assessed using Kaplan-Meier analysis.Results: During follow-up, 27.8% of participants sustained a subsequent fracture.Children with a baseline fracture had a significantly higher incidence of subsequent fractures than those without (38.5 vs 14.2 per 1,000 person-years).A baseline fracture was independently associated with increased future fracture risk (adjusted IRR: 2.48; 95% CI: 1.10-5.58;p = 0.028).Mean fracture-free survival was shorter in the baseline fracture group (4.8 1.6 vs 6.1 1.2 years; p = 0.031).Conclusion: Childhood fracture is an independent predictor of subsequent fracture risk, supporting its role as a marker for increased skeletal vulnerability and the need for targeted preventive strategies.