Ciminello Enrico, Modesti Andrea, Romanini Emilio, Lepore Stefano, Tucci Gabriele, Di Gennaro Stefano, Logroscino Giandomenico, Ciccarelli Paola, Falcone Tiziana, Torre Marina
Italian Implantable Prostheses Registry, Italian National Institute of Health, 00161 Rome, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
J Clin Med. 2024 Sep 27;13(19):5780. doi: 10.3390/jcm13195780.
: Proximal humeral fractures (PHFs) are common, especially in the elderly, and account for 4% to 10% of all fractures, with women more often affected than men. Treatments include conservative methods, internal fixation and arthroplasty, with surgical approaches increasingly being used due to technological advancements. This study analyzes the evolution of PHF treatments in Italy from 2001 to 2022, using data from the Italian Hospital Discharge Records (HDRs) Database, and includes a stratified analysis by age and sex. : Using HDR data from 2001 to 2022, records with ICD9-CM codes for proximal humeral fractures (812.0 and 812.1) among diagnoses were selected and categorized into three treatment groups: arthroplasty, fixation and conservative. Time series were analyzed with stratification by sex and age. : The extracted data included 486,368 records of PHFs, with 223,742 cases treated surgically (arthroplasty or internal fixation) and 262,626 treated conservatively; the average patient age was 66.6 years, with a higher proportion of women, especially among arthroplasty patients. Over time, the use of fixation and arthroplasty increased from 20% of treatments in 2001 to over 60% in 2022, with fixation becoming the most common treatment method by 2014 and arthroplasty significantly increasing among women, particularly in the 65-74 and 75-84 age groups. : The study shows that in Italy, over the past two decades, treatment for PHFs has shifted from conservative methods to a preference for internal fixation and increasingly for arthroplasty, particularly among women and patients aged 65-84, reflecting evolving trends and technological improvements.
肱骨近端骨折（PHF）很常见，尤其是在老年人中，占所有骨折的4%至10%，女性比男性更易受影响。治疗方法包括保守治疗、内固定和关节成形术，由于技术进步，手术方法的使用越来越多。本研究利用意大利医院出院记录（HDR）数据库的数据，分析了2001年至2022年意大利PHF治疗的演变情况，并按年龄和性别进行了分层分析。：利用2001年至2022年的HDR数据，选择诊断中具有肱骨近端骨折ICD9-CM编码（812.0和812.1）的记录，并分为三个治疗组：关节成形术、固定术和保守治疗。按性别和年龄分层分析时间序列。：提取的数据包括486,368例PHF记录，其中223,742例接受了手术治疗（关节成形术或内固定），262,626例接受了保守治疗；患者平均年龄为66.6岁，女性比例更高，尤其是在关节成形术患者中。随着时间的推移，固定术和关节成形术的使用从2001年的20%增加到2022年的60%以上，到2014年固定术成为最常见的治疗方法，关节成形术在女性中显著增加，尤其是在65 - 74岁和75 - 84岁年龄组。：研究表明，在意大利，在过去二十年中，PHF的治疗已从保守方法转向更倾向于内固定，并且越来越多地采用关节成形术，特别是在女性和65 - 84岁的患者中，这反映了不断变化的趋势和技术进步。
