Proximal humeral fractures in Finland

Abstract

Aims Proximal humeral fractures (PHFs) are common. There is increasing evidence that most of these fractures should be treated conservatively. However, recent studies have shown an increase in use of operative treatment. The aim of this study was to identify the trends in the incidence and methods of treatment of PHFs in Finland. Methods The study included all Finnish inhabitants aged ≥ 16 years between 1997 and 2019. All records, including diagnostic codes for PHFs and all surgical procedure codes for these fractures, were identified from two national registers. Data exclusion criteria were implemented in order to identify only acute PHFs, and the operations performed to treat them. Results During the 23-year study period, 79,676 PHFs were identified, and 14,941 operations were performed to treat them. The incidence of PHFs steadily increased. In 2019, the overall incidence was 105 per 100,000 person-years (105). The sex-adjusted incidence for females was 147.1 per 105, and the age-adjusted incidence for patients aged ≥ 80 years was 407.1 per 105. The incidence of operative treatment for PHFs rose during the first half of the study period and decreased during the second half. The use of plate osteosynthesis in particular decreased. In 2019, the incidence of operative treatment for PHFs was 13.2 per 105, with 604 operations. Conclusion Although the incidence of PHFs is steadily increasing, particularly in elderly females, the incidence of operative treatment is now decreasing, which is in line with current literature regarding their treatment. Cite this article: Bone Joint J 2022;104-B(1):150–156.

Maternal Smoking During Pregnancy and Offspring's Risk for Bone Fracture in Childhood and Adolescence

“…However, in Finland the number of bone fractures is smaller in the rural areas than in the vicinity of cities. ( 29,30 )…”

“…However, in Finland the number of bone fractures is smaller in the rural areas than in the vicinity of cities. (29,30) The register data did not include any information on measurements of bone strength or mineral content; therefore, comparison to previous studies, focusing on bone quality, could not be made. In addition, we had no access to other medical information of the cohort members, and therefore we could not take into account the possible bone-affecting diseases or medications, such as glucocorticoid exposure.…”

75 years young

“…It is always reassuring to read reflections from those heavily involved in the analysis of registry data about its advantages, disadvantages, value moving forward, and in particular, how it could be improved. [8][9][10][11][12][13][14][15][16][17][18][19][20] We also broach optimal management in acute trauma with an excellent annotation from Vallier, 21 which will hopefully give insight and stimulate debate.…”

“…It is always reassuring to read reflections from those heavily involved in the analysis of registry data about its advantages, disadvantages, value moving forward, and in particular, how it could be improved. 8-20…”

Functional outcome after nonoperative management of minimally displaced greater tuberosity fractures and predictors of poorer patient experience

“…The incidence of proximal humeral fractures is increasing. 1 Isolated greater tuberosity (GT) fractures account for 20% of all proximal humeral fractures, 2 and over half are minimally displaced (< 5 mm). 3 The GT lies in close proximity to, and is the insertion site for, soft-tissue structures, including three rotator cuff tendons, the biceps tendon, and capsule.…”