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. 2014 Aug;38(8):1697-704.
doi: 10.1007/s00264-014-2362-6. Epub 2014 May 25.

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

Christian Bahrs  1 , Tanja Stojicevic, Gunnar Blumenstock, Stig Brorson, Andreas Badke, Ulrich Stöckle, Bernd Rolauffs, Thomas Freude
Affiliations

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

Christian Bahrs et al. Int Orthop. 2014 Aug.

Erratum in

  • Int Orthop. 2014 Aug;38(8):1755. Tanja, Stojicevic [corrected to Stojicevic, Tanja]; Gunnar, Blumenstock [corrected to Blumenstock, Gunnar]; Stig, Brorson [corrected to Brorson, Stig]; Ulrich, Stöckle [corrected to Stöckle, Ulrich]; Bernd, Rolauffs [corrected to Rolauffs, Bernd]; Thomas

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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Figures

Fig. 1
Fig. 1
Proximal humeral fractures between 2006 and 2011
Fig. 2
Fig. 2
Proximal humeral fractures between 2006 and 2011 according to age and gender
Fig. 3
Fig. 3
Distribution (numbers/percentages) of the 815 proximal humeral fractures according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification
Fig. 4
Fig. 4
Number and the percentage of the four complexity groups
Fig. 5
Fig. 5
Distribution of proximal humeral fractures (complexity groups 1–4) according to age and gender with reference to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification
Fig. 6
Fig. 6
Distribution of proximal humeral fractures (complexity groups 1–4) according to age and gender with reference to the Neer classification
See this image and copyright information in PMC

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