Epidemiology of proximal humerus fractures managed in a trauma center

Abstract

Proximal humerus fractures (PHF) are osteoporotic fractures that affect women over 70 years of age. Like fractures of the femoral neck they have become a public health concern. As the population ages there is an increase in the number of people in poor general condition with an increased risk of falls on fragile bones. The incidence of these fractures has increased by 15% per year. All patients managed for PHF in our center in the past year were included in this prospective study (prospective cohort study; level 2). Three hundred and twenty-five patients were included with 329 fractures. There was a ratio of two women to one man. At the final follow-up 50 patients had died (15%) and 25 patients were lost to follow-up. The mean age was 70 years old. There were two types of risk factors. The first was fragile bones, and the second was patient specific risk of falls. The severity of the fracture increased with the age of the population. In the study by Charles S. Neer in 1970, 85% of PHF were not or were only slightly displaced, while this category percentage was only 42% in our study. Hospitalization was necessary in 43% of the cases in our study. Surgical management was necessary in 21%. This lack of relationship between the percentage of displaced fractures (58%) and the percentage of surgically treated fractures is a sign of the difficulties of managing this population, which is usually in poor general condition.

Shake Till You Break – Bilateral Neck of Humerus Fracture Post Seizure

“…Roux et al in 2012 reported that three percent of neck of humerus fracture are associated with epilepsy (Roux et al 2012). It is also known that posterior shoulder dislocation is more common following an epileptic seizure (Court-Brown et al 2001).…”

Functional outcome following surgical management of proximal humerus fracture in elderly

“…It accounts to about 4-5% of all fracture [3,4] . Studies show that more that about 70% of the patients who present with proximal humerus fractures are above the age of 50 years [5,6] .…”

Outcome of surgical treatment of proximal humerał fracture

“…Previous studies indicate that 80% of proximal humeral fractures are recognized as type 1 without displacement, according to the Neer classification [5], and can be successfully managed by non-surgical methods [6,7]. However, it should be noted that the later studies conducted by Court-Brown and Roux described a significantly lower percentage of minimally displaced fractures, ranging from 42% to 49% [8,9]. Literature on the subject of displaced or complex fractures describes no clear indications or qualification criteria for any particular invasive treatment, as a result of uncertain influence on prognosis [8,10].…”