Cette étude a pour but de calculer l'incidence des fractures de l'extrémité supérieure du fémur chez les sujets de plus de 60 ans parmi la population de Guadeloupe, qui comporte 440 000 habitants, d'origine africaine à 90 % et dont l'espérance de vie est comparable à celle de l'Europe.

Tous les cas de fractures intertrochantériennes ou cervicales vraies ont été recensés entre le 1^er janvier 2002 et le 1^er janvier 2005. Nous avons calculé l'incidence pour chaque tranche d'âge et nous avons comparé ce taux aux incidences retrouvées dans les autres pays.

Trois cent deux nouveaux cas ont été répertoriés entre 2002 et 2005. L'incidence guadeloupéenne chez les sujets de plus de 60 ans était en moyenne de 16,9/10 000, et de 22,2/10 000 chez les sujets de plus de 65 ans.

La Guadeloupe possède le plus bas taux mondial de fracture de hanche du sujet âgé, si l'on considère les populations d'espérance de vie comparable. L'étude des caractéristiques environnementales et génétiques de la population guadeloupéenne pourrait permettre une meilleure connaissance des facteurs de risque des fractures de hanche chez le sujet âgé.

The purpose of this study was to determine the incidence of hip fractures among the elderly population in Guadeloupe, a French Caribbean archipelago with 440,000 inhabitants who present two rarely associated characteristics: 90% of the population is of African descent and life expectancy is similar to that of European populations.

Using the recent census report, we established that in 2002, 61,000 persons aged 60 years or more (27,000 men and 34,000 women) lived in Guadeloupe. All new cases of hip fracture among the population aged 60 years or more were recorded in 2002, 2003, and 2004 in the seven islands that compose Guadeloupe. For each case, we noted patient age and gender, type of hip fracture, and treatment administered. We excluded open and pathologic fractures. Overall and age-specific incidence of hip fractures were determined and compared with rates reported for other countries.

Three hundred and two new cases of hip fracture were recorded from 2002 to 2005 in 211 women (70%) and 91 men (30%). The age of patients was 82 years on average (range 60-102). There were 134 neck fractures and 168 intertrochanteric fractures which were treated by osteosynthesis for 193 and arthroplasty for 108. Only one orthopedic treatment was noted. The incidence of hip fracture for people aged over 60 years was 16.9/10,000; for the population aged 65 years or more, it was 22.2/10,000.

Osteoporotic fracture is a pandemic problem. Incidence is increasing worldwide. Our findings demonstrate that Guadeloupeans are spared from this pathology. This population offers an interesting field for research into the causal mechanisms of osteoporotic fractures and potential means of prevention or screening.

The incidence of hip fractures among the elderly population in Guadeloupe is the lowest recorded in the world. We suggest that an environmental and genetic study in this spared population could provide interesting insight into the cause of hip fractures and appropriate means of prevention and screening among the elderly. The geographic and environmental characteristics of Guadeloupe make this area a unique zone of research and should enable new insight into the genetic and environmental factors involved in hip fractures.