| dc.description.abstract | Introduction Bone fractures are a major global health concern. Osteoporotic fractures affect the elderly, and high-energy fractures are common among children and young adults. Europe and the USA have higher fracture rates than Latin America, Africa, and Asia. Norway has one of the highest rates of fractures. Country of origin and an initial fracture are known factors that could lead to subsequent fractures. It is unclear whether individuals from non-Norwegian backgrounds face the same risk of recurring fractures as Norwegians. This study aimed to assess the risk of subsequent fractures in patients with an index forearm fracture by country of birth. Methods Data on forearm fractures treated in Norwegian hospitals from 2008 to 2019 were collected from the Norwegian Patient Register. Index forearm fractures were identified by the ICD-10, S52, whereas subsequent fractures included any ICD-10 fracture codes. Information about the country of birth was obtained from Statistics Norway. Age-standardized incidence rates were calculated by dividing the number of fractures by the years at risk after the initial fracture using direct standardization. The data underwent analysis through Cox proportional hazard regression. From the models, age-adjusted hazard ratios and corresponding 95% confidence intervals (CIs) were determined. Results Out of 143,476 forearm fracture patients, 35,361 experienced a second fracture of any type. The entire cohort of patients with forearm fractures encompassed a total of 767,531 person-years. Within this population, the overall incidence rate (IR) of subsequent fractures was 461 per 10,000 person-years. Women born in Norway had a high IR of recurrent fracture (IR 516 per 10,000 person-years). Norwegian-born individuals had a higher risk of subsequent fracture than most other regions of birth. However, the reported IRs of subsequent fractures were high compared to previously reported overall fracture rates, irrespective of birth category. Among individuals aged 18–44, there was no significant difference in the risk of subsequent fractures across various categories based on the country of birth. Forearm fractures were the most common type of fracture in all ethnic groups. Conclusion Individuals born outside Norway had a 0–37% lower risk of a recurrent fracture than Norwegian-born patients. The risk of subsequent fractures increased with age in all groups. The observed rate of recurrent fractures surpasses the general fracture rate for people of the same age in Norway. This indicates that patients with an index forearm fracture face a higher risk of sustaining new fractures compared to those without prior fractures. This study suggests providing secondary fracture prevention strategies to all patients with forearm fractures, regardless of their place of birth. | eng |