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Trends in epidemiology and patho-anatomical pattern of proximal humeral fractures

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An Erratum to this article was published on 20 June 2014

Abstract

Purpose

Proximal humeral fractures are common and frequently associated with osteoporosis. Little is known about the association between the patho-anatomical fracture pattern of proximal humeral fractures and patient characteristics. The purpose of this six year longitudinal registry analysis of proximal humeral fractures was to study overall numbers, certain predefined pathoanatomical patterns and distribution compared with specific patient characteristics.

Methods

Data of patients treated between 2006 and 2011 in a country hospital that provides care >95 % of the city’s hospitalised patients with fractures was retrospectively reviewed. Data were analysed according to patient characteristics of age, gender, comorbidity, accompanying injuries and radiological analysis of pathoanatomical fracture patterns based on Neer and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification.

Results

Eight hundred and fifteen proximal humeral fractures (67 % women/33 % men; mean age 66 years, range 19–99) were analysed. During the study period, an overall increase of 42.5 % was found: according to AO classification, 46 % were type A, 22 % type B and 32 % type C. Based on the Neer classification, 86 % were displaced, and 49 % were complex with more than three parts. Of complex fractures, 57 % were female patients >60 years. The number of complex fractures was five times higher in women >60 years than in men of the same age group.

Conclusions

An overall increase of inpatients with displaced proximal tibial fractures was documented. Interestingly, complex displaced proximal humeral fractures, especially in older women with comorbidities, accounted for the majority of cases. These results suggest that health-care planning and hospital-based therapeutic strategies should focus on this patient group.

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References

  1. Hagino H, Yamamoto K, Ohshiro H, Nakamura T, Kishimoto H, Nose T (1999) Changing incidence of hip, distal radius, and proximal humerus fractures in Tottori Prefecture. Japan Bone 24(3):265–270

    Article  CAS  Google Scholar 

  2. Jakob RP KT MK, Ganz R, Muller ME. . (1984) Classifications and aspects of treatment of fractures of the proximal humerus. In: JE Bateman and RP Welsh, Editors, Surgery of the shoulder, BC Decker, Philadelphia:330–343.

  3. Neer CS 2nd (1970) Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 52(6):1077–1089

    PubMed  Google Scholar 

  4. Palvanen M, Kannus P, Niemi S, Parkkari J (2006) Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 442:87–92

    Article  PubMed  Google Scholar 

  5. Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN (2011) Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg Am 93(2):121–131. doi:10.2106/JBJS.I.01505

    Article  PubMed Central  PubMed  Google Scholar 

  6. Lippuner K, Popp AW, Schwab P, Gitlin M, Schaufler T, Senn C, Perrelet R (2011) Fracture hospitalizations between years 2000 and 2007 in Switzerland: a trend analysis. Osteoporos Int 22(9):2487–2497. doi:10.1007/s00198–010–1487–8

    Article  CAS  PubMed  Google Scholar 

  7. Kristiansen B, Barfod G, Bredesen J, Erin-Madsen J, Grum B, Horsnaes MW, Aalberg JR (1987) Epidemiology of proximal humeral fractures. Acta Orthop Scand 58(1):75–77

    Article  CAS  PubMed  Google Scholar 

  8. Sonderegger J, Simmen HP (2003) Epidemiology, treatment and results of proximal humeral fractures: experience of a district hospital in a sports- and tourism area. Zentralbl Chir 128(2):119–124

    Article  CAS  PubMed  Google Scholar 

  9. Edelson G, Saffuri H, Obid E, Vigder F (2009) The three-dimensional anatomy of proximal humeral fractures. J Shoulder Elbow Surg 18(4):535–544

    Article  PubMed  Google Scholar 

  10. Court-Brown CM, Garg A, McQueen MM (2001) The epidemiology of proximal humeral fractures. Acta Orthop Scand 72(4):365–371. doi:10.1080/000164701753542023

    Article  CAS  PubMed  Google Scholar 

  11. Bahrs C, Bauer M, Blumenstock G, Eingartner C, Bahrs SD, Tepass A, Weise K, Rolauffs B (2013) The complexity of proximal humeral fractures is age and gender specific. J Orthop Sci 18(3):465–470. doi:10.1007/s00776-013-0361-x

    Article  PubMed  Google Scholar 

  12. Neer CS 2nd (2002) Four-segment classification of proximal humeral fractures: purpose and reliable use. J Shoulder Elbow Surg 11(4):389–400. doi:10.1067/mse.2002.124346

    Article  PubMed  Google Scholar 

  13. Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, Thaler H, Szivak M, Amrein K, Borgstrom F (2013) Epidemiology of proximal humeral fractures in Austria between 1989 and 2008. Osteoporos Int. doi:10.1007/s00198-013-2339-0

    Google Scholar 

  14. Kannus P, Palvanen M, Niemi S, Sievanen H, Parkkari J (2009) Rate of proximal humeral fractures in older Finnish women between 1970 and 2007. Bone 44(4):656–659. doi:10.1016/j.bone.2008.12.007

    Article  PubMed  Google Scholar 

  15. Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, Boileau P, de Peretti F (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res 98(6):715–719. doi:10.1016/j.otsr.2012.05.013

    Article  CAS  PubMed  Google Scholar 

  16. Tamai K, Ishige N, Kuroda S, Ohno W, Itoh H, Hashiguchi H, Iizawa N, Mikasa M (2009) Four-segment classification of proximal humeral fractures revisited: a multicenter study on 509 cases. J Shoulder Elbow Surg 18(6):845–850. doi:10.1016/j.jse.2009.01.018

    Article  PubMed  Google Scholar 

  17. Pressekonferenz SB (2009) Bevölkerung Deutschlands bis 2060. Statistisches Bundesamt, Berlin

    Google Scholar 

  18. O’Brien MS, Donnell A, Miller J, Iven VG, Pascale M (2013) An abnormal bone lesion of the scapula in a collegiate basketball player: a case report. J Athl Train 48(6):859–863. doi:10.4085/1062-6050-48.3.07

    Article  PubMed  Google Scholar 

  19. Duckworth AD, Bugler KE, Clement ND, Court-Brown CM, McQueen MM (2014) Nonoperative management of displaced olecranon fractures in low-demand elderly patients. J Bone Joint Surg Am 96(1):67–72. doi:10.2106/JBJS.L.01137

    Article  PubMed  Google Scholar 

  20. Gimigliano F, Iolascon G, Riccio I, Frizzi L, Gimigliano R (2013) Post-surgical rehabilitative approach to fragility fractures. Aging Clin Exp Res 25(Suppl 1):23–25. doi:10.1007/s40520-013-0094-x

    Article  Google Scholar 

  21. Lippuner K, Johansson H, Kanis JA, Rizzoli R (2009) Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. Osteoporos Int 20(7):1131–1140. doi:10.1007/s00198-008-0779-8

    Article  CAS  PubMed  Google Scholar 

  22. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: A review. Injury 37(8):691–697. doi:10.1016/j.injury.2006.04.130

    Article  PubMed  Google Scholar 

  23. Brorson S, Bagger J, Sylvest A, Hrobjartsson A (2009) Diagnosing displaced four-part fractures of the proximal humerus: a review of observer studies. Int Orthop 33(2):323–327. doi:10.1007/s00264-008-0591-2

    Article  PubMed Central  PubMed  Google Scholar 

  24. Tepass A, Blumenstock G, Weise K, Rolauffs B, Bahrs C (2013) Current strategies for the treatment of proximal humeral fractures: an analysis of a survey carried out at 348 hospitals in Germany, Austria, and Switzerland. J Shoulder Elbow Surg 22(1):e8–14. doi:10.1016/j.jse.2012.04.002

    Article  PubMed  Google Scholar 

  25. Huttunen TT, Launonen AP, Pihlajamaki H, Kannus P, Mattila VM (2012) Trends in the surgical treatment of proximal humeral fractures - a nationwide 23-year study in Finland. BMC Musculoskelet Disord 13:261. doi:10.1186/1471-2474-13-261

    Article  PubMed Central  PubMed  Google Scholar 

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Bahrs, C., Tanja, S., Gunnar, B. et al. Trends in epidemiology and patho-anatomical pattern of proximal humeral fractures. International Orthopaedics (SICOT) 38, 1697–1704 (2014). https://doi.org/10.1007/s00264-014-2362-6

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  • DOI: https://doi.org/10.1007/s00264-014-2362-6

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