Humeral fractures due to low-energy trauma: an epidemiologicalsurvey in patients referred to a large emergency department in Northern Italy

Summary: This survey describes the epidemiology of approximately 1800 low-energy humeral fractures seen in a large emergency department in Northern Italy over 7 years (2007–2013), highlighting the differences from previous Italian studies. Purpose: The purpose of this study was to determine the incidence of humeral fractures due to low-energy trauma in patients 40 years of age or older referred to a large Emergency Department (Parma, Northern Italy) in a 7-year period (2007–2013). Methods: All humeral fractures referred to the emergency department of the Academic Hospital of Parma (the main hospital in the province with a catchment area of approximately 345,000) were retrieved from the hospital database using both ICD-9CM codes and text strings. The diagnosis of humeral fracture due to low-energy trauma was confirmed by medical records and X-ray reports, after exclusion of injuries due to a clear-cut high-energy trauma or cancer. Results: The query identified 1843 humeral fractures (1809 first fractures), with a clear predominance in women (78 %). Fractures of the proximal humerus represented the large majority of humeral fractures (more than 85 %), with an incidence progressively increasing with age (more than 60-fold in women and 20-fold in men). Simultaneous fractures (hip in particular) were frequent especially after 85 years of age (1 out of 8 cases). When compared to other Italian studies, the incidence of humeral fractures was significantly lower than that derived from discharge data corrected for hospitalization rate (standardized rate ratio 0.74; p < 0.001), while the pattern of age-related changes was significantly different from that computed by applying the ratio between hip and humeral fractures observed in Malmö, Sweden, to the Italian hip fracture rates. Conclusions: This study gives an up-to-date description of the epidemiology of low-energy humeral fractures in Italy. Our results partly differ from previous Italian studies based on indirect estimations.