TY - JOUR

T1 - Epidemiology and trends in management of acute proximal humeral fractures in adults

T2 - an observational study of 137,436 cases from the Danish National Patient Register, 1996–2018

AU - Brorson, Stig

AU - Viberg, Bjarke

AU - Gundtoft, Per

AU - Jalal, Bamo

AU - Ohrt-Nissen, Søren

N1 - Publisher Copyright: © 2022 The Author(s). Published by Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation.

PY - 2022

Y1 - 2022

N2 - Background and purpose — Proximal humeral fractures (PHF) can be managed surgically or non-surgically. Locking plates have been the preferred head-preserving surgical technique while hemiarthroplasty (HA) or reverse shoulder arthroplasty (RSA) have been used in joint replacement sur-gery. We describe the epidemiology and trends in management of acute PHF in Denmark with a focus on (i) changes in the incidence of PHF; (ii) changes in the proportion of surgical cases; and (iii) changes in preferred surgical techniques. Patients and methods — Data on diagnoses and interventions was retrieved from the Danish National Patient Reg-ister. Patients aged 18 years and above were included. Surgical treatment was defined as the diagnosis of PHF combined with a predefined surgical procedure code within 3 weeks of injury. Data on plate osteosynthesis, HA, RSA, and “other tech-niques” was retrieved. Non-surgical treatment was defined as no relevant surgical procedure code within 3 weeks. Results — We identified 137,436 PHF (72% women) in the Danish National Patient Register. The overall mean incidence was 138/100,000/year (500 for women 60 years or above). Non-surgical treatment accounted for 119,966 (87%). The 17,470 surgical procedures included 42% locking plates, 34% arthroplasties, and 25% other techniques. The rate of surgery declined from 17% in 2013 to 11% in 2018. Interpretation — The overall incidence of PHF remained stable between 1996 and 2018 but the absolute number increased. The approach to PHF remains predominantly non-surgical. The number of surgeries in Denmark have decreased since 2013, especially for locking plates and HA, while RSA is increasingly used.

AB - Background and purpose — Proximal humeral fractures (PHF) can be managed surgically or non-surgically. Locking plates have been the preferred head-preserving surgical technique while hemiarthroplasty (HA) or reverse shoulder arthroplasty (RSA) have been used in joint replacement sur-gery. We describe the epidemiology and trends in management of acute PHF in Denmark with a focus on (i) changes in the incidence of PHF; (ii) changes in the proportion of surgical cases; and (iii) changes in preferred surgical techniques. Patients and methods — Data on diagnoses and interventions was retrieved from the Danish National Patient Reg-ister. Patients aged 18 years and above were included. Surgical treatment was defined as the diagnosis of PHF combined with a predefined surgical procedure code within 3 weeks of injury. Data on plate osteosynthesis, HA, RSA, and “other tech-niques” was retrieved. Non-surgical treatment was defined as no relevant surgical procedure code within 3 weeks. Results — We identified 137,436 PHF (72% women) in the Danish National Patient Register. The overall mean incidence was 138/100,000/year (500 for women 60 years or above). Non-surgical treatment accounted for 119,966 (87%). The 17,470 surgical procedures included 42% locking plates, 34% arthroplasties, and 25% other techniques. The rate of surgery declined from 17% in 2013 to 11% in 2018. Interpretation — The overall incidence of PHF remained stable between 1996 and 2018 but the absolute number increased. The approach to PHF remains predominantly non-surgical. The number of surgeries in Denmark have decreased since 2013, especially for locking plates and HA, while RSA is increasingly used.

U2 - 10.2340/17453674.2022.4578

DO - 10.2340/17453674.2022.4578

M3 - Journal article

C2 - 36148615

AN - SCOPUS:85138396251

VL - 93

SP - 750

EP - 755

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

ER -