Secular trends in distal humeral fractures of elderly women: Nationwide statistics in Finland between 1970 and 2007
Introduction
Epidemiologic information on distal humeral fractures is very scarce. Although these fractures are not as common as those at the distal forearm, their treatment is demanding and expensive, and, they usually require surgical treatment with accompanying long follow-up, intense rehabilitation, and increased risk for considerable morbidity [1], [2].
The proportion of distal humeral fractures constitutes about 5% of all osteoporotic fractures in persons 60 years old and older. This proportion decreases to 2% in 80 years old and older people [3], [4]. Nevertheless, in women the fracture incidence increases every decade after the age 20 [5].
Previously we reported that the number and incidence of low-trauma distal humeral fractures among Finnish elderly women clearly increased during the last three decades of the 20th century, from the early 1970s to the late 1990s [4]. However, because a decreasing trend in the number and incidence of some other types of low-trauma fractures has been seen in the beginning of 21st century [6], [7], [8], [9], [10], [11], [12], we wanted to clarify the recent development in the distal humeral fractures, as well. For prediction of the number of patients requiring treatment for low-trauma fractures, such as distal humeral fractures, it is very important to know exactly whether the number of fractures is changing differently than can be accounted for by demographic changes alone.
Section snippets
Methods
In accord with other epidemiologic studies [4], [11], [13], [14], [15], we defined a low-trauma fracture of the distal humerus as a fracture occurring in a person 60 years of age or older as a consequence of low or moderate energy trauma (typically a slip, trip, or fall from standing height or less) and collected from the National Hospital Discharge Register (NHDR) all Finnish women 60 years and older who were admitted to our hospitals from 1970 to 2007 for primary treatment of such fracture.
Results
The annual total number of low-trauma distal humeral fractures among Finnish women 60 years of age or older increased between 1970 (42 fractures) and 1998 (224 fractures), the average increase being 15.5% per year. Conversely, between 1999 and 2007 the number of fractures decreased (down to 192 fractures in 2007). The overall incidence of these fractures also increased during the first 29 study years, but thereafter, the fracture incidence decreased (Fig. 1A).
In the age-adjusted fracture
Discussion
In this nationwide study we used the whole Finnish female population 60 years and older to analyze the time trends for the absolute numbers and incidences of low-trauma distal humeral fractures from 1970 to 2007. Increasingly tighter control of healthcare resources makes it necessary to predict the fracture rates in the near future. Such a prediction requires knowledge of whether the number of fractures is increasing more rapidly than can be accounted for by the demographic changes alone. An
Conflicts of interest statement
The authors have no conflicts of interest to declare.
Acknowledgments
This study was funded by the Competitive Research Funding of the Pirkanmaa Hospital District, Tampere, Finland, and, the Juho Vainio Foundation, the Paulo Foundation, and the Finnish Ministry of Social Affairs and Health, Helsinki, Finland.
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