Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, UK.
Bone Joint J. 2020 Nov;102-B(11):1475-1483. doi: 10.1302/0301-620X.102B11.BJJ-2020-0993.R1.
The aim of this study was to determine the current incidence and epidemiology of humeral diaphyseal fractures. The secondary aim was to explore variation in patient and injury characteristics by fracture location within the humeral diaphysis.
Over ten years (2008 to 2017), all adult patients (aged ≥ 16 years) sustaining an acute fracture of the humeral diaphysis managed at the study centre were retrospectively identified from a trauma database. Patient age, sex, medical/social background, injury mechanism, fracture classification, and associated injuries were recorded and analyzed.
A total of 900 fractures (typical 88.9%, n = 800/900; pathological 8.3%, n = 75/900; periprosthetic 2.8%, n = 25/900) were identified in 898 patients (mean age 57 years (16 to 97), 55.5% (n = 498/898) female). Overall fracture incidence was 12.6/100,000/year. For patients with a typical fracture (n = 798, mean age 56 years (16 to 96), 55.1% (n = 440/798) female), there was a bimodal distribution in men and unimodal distribution in older women (Type G). A fall from standing was the most common injury mechanism (72.6%, n = 581/800). The majority of fractures involved the middle-third of the diaphysis (47.6%, n = 381/800) followed by the proximal- (30.5%, n = 244/800) and distal-thirds (n = 175/800, 21.9%). In all, 18 injuries (2.3%) were open and a radial nerve palsy occurred in 6.7% (n = 53/795). Fractures involving the proximal- and middle-thirds were more likely to occur in older (p < 0.001), female patients (p < 0.001) with comorbidities (p < 0.001) after a fall from standing (p < 0.001). Proximal-third fractures were also more likely to occur in patients with alcohol excess (p = 0.003) and to be classified as AO-Orthopaedic Trauma Association type B or C injuries (p < 0.001).
This study updates the incidence and epidemiology of humeral diaphyseal fractures. Important differences in patient and injury characteristics were observed based upon fracture location. Injuries involving the proximal- and middle-thirds of the humeral diaphysis should be considered as fragility fractures. Cite this article: 2020;102-B(11):1475-1483.
本研究旨在确定肱骨干骨折的当前发生率和流行病学。次要目的是通过肱骨干骨折的位置来探讨患者和损伤特征的变化。
在十年期间（2008 年至 2017 年），从创伤数据库中回顾性确定了在研究中心接受急性肱骨干骨折治疗的所有成年患者（年龄≥16 岁）。记录并分析了患者年龄、性别、医疗/社会背景、损伤机制、骨折分类和相关损伤。
在 898 名患者中发现了 900 例骨折（典型骨折 88.9%，n=800/900；病理性骨折 8.3%，n=75/900；假体周围骨折 2.8%，n=25/900）（平均年龄 57 岁（16 至 97），55.5%（n=498/898）为女性）。总体骨折发生率为 12.6/100,000/年。对于典型骨折患者（n=798，平均年龄 56 岁（16 至 96），55.1%（n=440/798）为女性），男性呈双峰分布，老年女性呈单峰分布（G 型）。跌倒伤是最常见的损伤机制（72.6%，n=581/800）。大多数骨折发生在骨干中段（47.6%，n=381/800），其次是骨干近端（30.5%，n=244/800）和骨干远端（n=175/800，21.9%）。总共 18 例（2.3%）为开放性骨折，6.7%（n=53/795）发生桡神经麻痹。跌倒伤后，发生在骨干近端和中段的骨折更可能发生在年龄较大（p<0.001）、女性（p<0.001）和有合并症的患者（p<0.001）中。近端三分之一的骨折也更可能发生在酒精过量的患者中（p=0.003），并被归类为 AO 骨科创伤协会 B 或 C 型损伤（p<0.001）。
本研究更新了肱骨干骨折的发病率和流行病学。根据骨折位置，观察到患者和损伤特征的重要差异。骨干近端和中段的骨折应视为脆性骨折。
