Incidence of Low-energy Upper Extremity Fractures and the Risk Factors in Chinese People 50 years or Older

Abstract

Objective: To investigate the incidence of low-energy upper extremity fractures and identify the associated risk factors in Chinese people aged 50 years or older.

Methods: This study was a part of the Chinese National Fracture Survey, which was performed between January and May 2015 and aimed to investigate the epidemiology of traumatic fractures in China in 2014. The China National Fracture Study (CNFS) was registered with the Chinese Clinical Trial Registry (number ChiCTR-EPR-15005878). A stratified multistage cluster randomized sampling method was used to recruit subjects and the survey was conducted through a questionnaire. The relevant results have been published elsewhere. In the current study, 154 099 Chinese men and women aged 50 years or older were included for data collection and analysis. Low-energy fractures were defined as fractures that were caused by simple falls from standing height. Individuals who had low-energy upper extremity fractures were included in the case group and the remainder were included in the control group. Univariate and multivariate logistics regression analysis models were constructed to investigate the independent risk factors, after adjustment for confounding variables.

Results: In total, 184 patients sustained low-energy upper extremity fractures in 2014, indicating that the overall incidence was 119.4/100 000 persons, with 57.4 and 180.9/100 000 person-years in men and women. Approximately 80% of fractures occurred at home and on the common road (other than high way). In men, alcohol consumption (OR, 2.12; 95%CI, 1.11-4.06), residence at ≥2nd floor without an elevator (OR, 2.86; 95%CI, 1.16-7.06), sleep duration<7 h/day (OR, 2.77; 95%CI, 1.42-5.37), and history of past fractures (OR, 3.10; 95%CI, 1.21-7.93) were identified as significant risk factors. In women, obesity (BMI ≥ 28.0) (OR, 1.86; 95%CI, 1.31-2.66), living in the central region in China (OR, 1.53; 95%CI, 1.01-2.31), living at a higher latitude (40°-49.9°N) (OR, 1.79; 95%CI, 1.02-3.14), alcohol consumption (OR, 2.40; 95%CI, 1.58-3.63), more births (OR, 1.45; 95%CI, 1.15-1.83), sleep duration <7 h/day (OR, 2.21; 95%CI, 1.53-3.20), and history of past fracture (OR, 2.70; 95%CI, 1.52-4.80) were identified as significant risk factors.

Conclusion: Based on these results, health policies that focus on decreasing alcohol consumption and encouraging individuals to improve their quality and duration of sleep should be implemented in China. The significance of moving to a ground floor or to a building equipped with an elevator for men, and maintaining a healthy body weight for women should be emphasized to prevent upper extremity fractures.

Keywords: Epidemiology; Low-energy fracture; Mid- and elderly-aged; Upper extremity.

Figure 1

Places where low‐energy fracture occurred in 2014. Home and common road (other than high way) were the most common places that low‐energy upper extremity fractures occurred, representing 40.2% and 39.1%, respectively.

Figure 2

The trend of the incidence rate of low‐energy upper fractures with aging, in men and women. There was an obvious one peak in women, at the age of 55–59 years old, and a valley at the age of 75–80 years old; however, for men, the trend line is almost flat, without great fluctuation.