Epidemiological Profile of Patients With Proximal Humerus Fracture Treated at Hospital São Paulo, Brazil

Oliveira, Ana Paula Cortes de; Mestieri, Mariana Christovam; Pontin, José Carlos Baldocchi

doi:10.1590/1413-785220152305143730

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…The essential ascertainment of our study found that the overall incidence of PHFs was 3.8 per 100,000 cases in 2018 and 4.45 per 100,000 cases in 2019. These figures are lower than the incidence rates reported in previous studies, which ranged from 9.49 to 15.45 per 100,000 cases [7][8][9][10].…”

Section: Discussioncontrasting

confidence: 71%

“…The mean age of patients included in this study was 52.4 years, which is much younger than the average age reported in other populations. For example, Court-Brown et al [1] reported an average age of 64.8 years in the British population, while Olivera et al [9] reported an average age of 65.2 years in the Brazilian population, and Palvanen et al [11] reported an average age of 75.5 years in the Finnish population. The fact that 85% of Qatar's population falls within the 15-65 age range [12] supports the idea that the bimodal distribution of PHFs in the population may be due to the different types of trauma experienced by different age and gender groups.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of proximal humerus fractures in Qatar

Alzobi

Salman

Derbas

et al. 2023

Eur J Orthop Surg Traumatol

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Objective This study aimed to investigate the epidemiological characteristics and treatment options of proximal humerus fractures at a level one trauma center and to compare our data with the current literature. Methods A retrospective review was conducted on all patients diagnosed and treated for proximal humerus fractures at Hamad General Hospital, a level one trauma center, between January 2018 and December 2019. Age, gender, mechanism of injury, fracture classification, mode of treatment, implant type, length of hospital stay, associated injuries and complications were analyzed. Results A total of 190 patients with a mean age of 52.4 years were included; 56.8% were males. The incidence of proximal humerus fracture was 4.1/100,000 per year. Falling from a standing height was the most common cause of injury (50.5%). Additionally, Neer’s two-part fracture was found to be the most common type (n = 132, 69%). Forty-one patients (21.3%) had other associated injuries. Most fractures were treated nonoperatively with an arm sling (n = 138, 72.6%). Conclusion In summary, the incidence of proximal humerus fractures during the two-year study period was found to be 4.1 per 100,000 persons per year. Our results showed a lower incidence of proximal humerus fractures with a predominance of males and younger patients in Qatar’s population compared to females and older patients in the developed countries. Our results may contribute to the development of effective strategies for preventing and treating proximal humerus fractures, and can provide important data for further high-level clinical research. Level of evidence IV.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Epidemiology of proximal humerus fractures in Qatar

Alzobi

Salman

Derbas

et al. 2023

Eur J Orthop Surg Traumatol

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“…Most other series have reported a much greater proportion of female patients. 19 The NSA represents the angle between the diaphysial axis and the humeral neck axis, drawn as perpendicular to the base of the head. 20,21 The normal value of NSA is approximately 135 .…”

Section: Discussionmentioning

confidence: 99%

Correlation of radiological parameters to functional outcome in complex proximal humerus fracture fixation: A study of 127 cases

Dheenadhayalan

Prasad

Devendra

et al. 2019

J Orthop Surg (Hong Kong)

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The purpose of this study is to analyze the radiological and functional outcome of complex proximal humerus fractures treated by open reduction and plate fixation, and how radiological parameters correlate with functional outcome. Design: Retrospective study. Setting: Level-1 trauma center. Patients/methods: One hundred twenty-seven patients were analyzed, with a mean follow-up of 5 (3-7) years. Outcome measurements: Radiological parameters studied were neck-shaft angle (NSA), greater tuberosity (GT) to articular surface (AS) distance, medial hinge reduction, and presence (or absence) of calcar screw. Functional outcome evaluated by DASH and Constant-Murley (C-M) score. Results: The mean age is 53.8 years. All patients had a union in 14 (12-18) weeks. The mean NSA is 135 (112-155). One hundred and thirteen patients with an NSA of >120 had a good functional outcome. Fourteen patients with NSA 120 had shoulder abduction <90. The mean GT to AS distance is 7.2 mm (À2 to 16). The superior displacement of GT above AS is associated with abduction of <90 (16 patients). The mean medial gap is 3 mm (0-17). In 14 patients with a medial gap of >4 mm and without calcar screw, varus collapse is observed. All patients had a good outcome on DASH score and 122 patients had good to excellent outcome on CM score. Five patients with poor outcome on CM score had NSA <120 and displacement of GT above AS. Conclusion: Radiographic indicators for poor outcome are varus angulation with NSA <120 , superior displacement of GT above AS, the presence of medial gap >4 mm, and absence of calcar specific screw. This "terrible triad" of proximal humerus fracture should be avoided during operative fixation.

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“…Proximal humerus fracture is the third most common fracture, after distal radius fracture and proximal femur fracture; it affects a considerable number of adult and elderly patients due to trauma or falls [ 1 ]. The prevalence of proximal humerus fracture in hospital emergency care is substantial and corresponds to approximately 80% of humerus fractures and 5% of total fractures [ 2 ]. This prevalence continues to rise with extended life span and increased outdoor activity.…”

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confidence: 99%

Inter-rater agreement on proximal humerus fracture treatment in Korea

2022

Clin Shoulder Elbow

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Proximal fracture, after distal radius fracture and proximal femur it affects a considerable number of adult and elderly patients due to trauma or falls [1]. The prevalence of proximal humerus fracture in hospital emergency care is substantial and corresponds to approximately 80% of humerus fractures and 5% of total fractures [2]. This prevalence continues to rise with extended life span and increased outdoor activity.A standardized classification system is needed for several purposes including communication between medical professionals, standardization of research, and, most importantly, for use in prognostication and to guide management and intervention. However, inter-rater agreement for classification and treatment selection of proximal humerus fractures is quite low, and decision making for the treatment of these fractures is challenging even for experienced surgeons [3,4]. To overcome these difficulties, several approaches, such as use of multiple Neer classifications, AO/OTA (Orthopaedic Trauma Association) [5], three-dimensional computed tomography (3D CT) [6], 3D handheld modeling [4,7], and artificial intelligence [8] have been reported. Thus, research on current approaches to treatment of proximal humerus fracture would be helpful to surgeons.A study by Kim et al. [9] in Clinics in Shoulder and Elbow investigated inter-rater and intra-rater agreement with respect to

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Epidemiological Profile of Patients With Proximal Humerus Fracture Treated at Hospital São Paulo, Brazil

Cited by 6 publications

References 19 publications

Epidemiology of proximal humerus fractures in Qatar

Epidemiology of proximal humerus fractures in Qatar

Correlation of radiological parameters to functional outcome in complex proximal humerus fracture fixation: A study of 127 cases

Inter-rater agreement on proximal humerus fracture treatment in Korea

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