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

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• 作者：Christian Bahrs (1)
  Stojicevic Tanja (1)
  Blumenstock Gunnar (2)
  Brorson Stig (3)
  Andreas Badke (1)
  St?ckle Ulrich (1)
  Rolauffs Bernd (1)
  Freude Thomas (1)
  
• 关键词：Epidemiology ; Proximal humeral fractures ; Proximal humerus fractures ; Shoulder fractures ; Classification ; Neer ; AO ; OTA
• 刊名：International Orthopaedics
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：38
• 期：8
• 页码：1697-1704
• 全文大小：1,052 KB
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• 作者单位：Christian Bahrs (1)
  Stojicevic Tanja (1)
  Blumenstock Gunnar (2)
  Brorson Stig (3)
  Andreas Badke (1)
  St?ckle Ulrich (1)
  Rolauffs Bernd (1)
  Freude Thomas (1)
  
  1. Clinic for Traumatology and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik Tübingen, Eberhard-Karls University Tübingen, Schnarrenbergstr, 95, 72074, Tübingen, Germany
  2. Institut für Klinische Epidemiologie und angewandte Biometrie, Eberhard-Karls-Universit?t Tübingen, Silcherstra?e 5, 72076, Tübingen, Germany
  3. Department of Orthopaedic Surgery, Herlev University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
  
• ISSN：1432-5195

文摘

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 19-9) 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.