# Incidence of proximal tibia fractures in adults in Sweden show higher rates in women and a marked increase among young women

## TL;DR

This study shows that the rate of proximal tibia fractures in Sweden has increased, especially among young women, while surgical treatment rates have remained stable.

## Contribution

The study provides the first nationwide analysis of proximal tibia fracture incidence and treatment patterns in Sweden over a 13-year period.

## Key findings

- The overall incidence of proximal tibia fractures increased by 9.3% from 2011 to 2023.
- Young women (20–29 years) experienced a 100% increase in fracture rates during the study period.
- Women over 80 had the highest incidence, though it decreased by 18% over the study period.

## Abstract

Proximal tibia fractures (PTF) account for ~ 1% of all adult fractures and show a bimodal age distribution, occurring after high-energy trauma in younger individuals and low-energy fragility fractures in the elderly. Contemporary nationwide data on incidence and management are lacking for Sweden. The aim of the present study was therefore to investigate the incidence and management of PTFs in Sweden using nationwide register data. Specifically, we sought to (1) determine the incidence of PTFs over time, (2) describe demographic characteristics of affected patients, and (3) analyse treatment patterns, including the use of acute arthroplasty. Using the Swedish National Patient Register, all patients ≥ 18 years of age, with a diagnosis of PTF (ICD-10 S82.1) between 2011 and 2023 were included. Incidence rates were calculated using national population data and reported per 100,000 person-years. Patient demographics and treatment patterns, including surgical methods, were analysed and compared between sex and age groups. A total of 38,053 patients with PTF were identified (60% women, mean age 57 years). The overall incidence increased from 36.7 per 100,000 person-years in 2011 to 40.1 in 2023 (+ 9.3%). Incidence remained stable in men (31.0 to 30.3), while it increased by 18.5% in women (42.2 to 50.0). The highest incidence-rate throughout the study period was observed among women aged ≥ 80 years, although rates in this group declined from 111.0 per 100,000 person-years 2011 to 90.3 in 2023 (–18%). The largest relative increase occurred in women aged 20–29 years (12.7 to 25.4; +100%). Between 2011 and 2023, 29% of patients underwent surgery, most commonly plate fixation (71.6%). The incidence of PTFs in Sweden has increased modestly over the past decade, driven primarily by a rise among young women. Up to the age of 50, the majority of PTFs were sustained by men (n = 7849, 57.6%), whereas above 50 the vast majority were sustained by women (n = 17249, 70.6%). Surgical treatment rate has been stable over the 13 years study period, with the large majority being treated with plate fixation.

The online version contains supplementary material available at 10.1038/s41598-026-39751-6.