Assessment of incidence and various demographic risk factors of traumatic humeral shaft fractures in China

Abstract

As a sub-study of the China National Fracture Study, this study aimed to better determine the incidence and risk factors of humeral shaft fracture in mainland China. We obtained all the data on humeral shaft fracture from the China National Fracture Study reported in 2017. Trained research teams personally interviewed all qualifying household members using a standardised questionnaire. A total of 512,187 (259649 boys and men, 252538 girls and women) questionnaires were collected and analysed from 112 neighbourhood communities and 223 administrative villages using stratified random sampling and the probability proportional to size method. The population-weighted incidence rate of humeral shaft fracture was 7.22 (95% confidence interval 4.90, 9.55) per 100,000 populations in 2014. Previous fracture history was an independent risk factor in adults of both sexes. Smoking was identified as an independent risk factor for humeral shaft fracture for men. Alcohol consumption and menstruation ceasing before the age of 46 years were considered as independent risk factors for women. Given the above data, specific public-health policies focusing on promoting a smoke-free environment and reducing alcohol intake should be encouraged. People who have had a fracture and women whose menstruation had ceased before the age of 46 should be vigilant against humeral shaft fracture.

Fracture, nonunion and postoperative infection risk in the smoking orthopaedic patient: a systematic review and meta-analysis

“…Meta-analysis of eight studies (10 study entries) 25 , 28 – 30 , 33 , 35 , 40 , 41 reporting on fracture risk at any anatomical site revealed a significant association between smoking and risk for any fracture (RR: 1.75; 95% CI: 1.10–2.80; p = 0.019; Fig. 2 ).…”

“…24 – 47 Mean NOS score for these studies was 6.9 ± 1.5 points. Six of these studies reported separate results for males and females, 26 , 28 , 30 , 31 , 46 , 47 one provided individual results for fractures at the trochanteric region and femoral neck, 32 and one study presented different results for fractures at any location and hip fractures. 33 The resulting meta-analysis thus comprised 32 study entries, involving 2,037,159 patients, of whom 518,995 (25.5%) were active smokers.…”

“…Notably, these numbers also included three study entries reporting on identical patient cohorts ( Table 1 ). 25 , 28 , 30 Of the 24 studies analysed, 11 were retrospective studies (45.8%; level IV), 25 , 27 – 30 , 34 , 36 , 39 , 40 , 42 , 43 11 were longitudinal population-based cohort studies (45.8%; level III), 31 – 33 , 35 , 37 , 38 , 41 , 44 – 47 one a prospective study (4.2%; level III), 24 and one a large retrospective study (4.2%; level III). 26 Overall relative risk (RR) for smokers (regardless of fracture site) was 1.46 (95% confidence interval [CI]: 1.23–1.72; p < 0.001; Fig.…”

“…No significant publication bias was found (Harbord’s p = 0.505). After excluding four studies investigating fracture incidences in a large Chinese population (> 400,000 patients), 25 , 28 , 30 , 35 and one study with stress fracture as the endpoint, 40 sensitivity analysis revealed a significant association between smoking and increased risk for fractures at other sites than vertebrae or hip (RR: 1.50; 95% CI: 1.25–1.80; p < 0.001), and low heterogeneity ( I 2 = 16.9%).…”

Biomechanical Features of Comminuted Humeral Shaft Fractures

“…Особливістю цих переломів є потенційний ризик пошкодження судинно-нервових утворень кістковими відламками, які зміщується під дією ретракції м'язів. Це може відбуватися під час безпосередньої травми, наданні першої медичної допомоги та на госпітальному етапі [4].…”