Skip to main content

Advertisement

Log in

Humeral Fractures in South-Eastern Australia: Epidemiology and Risk Factors

  • Original Research
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Abstract

In this study, we report the epidemiology and risk factors for humeral fractures (proximal humerus and shaft) among men and women residing in south-eastern Australia. Incident fractures during 2006 and 2007 were identified using X-ray reports (Geelong Osteoporosis Study Fracture Grid). Risk factors were identified using data from case–control studies conducted as part of the Geelong Osteoporosis Study. Median age of fracture was lower in males than females for proximal humerus (33.0 vs 71.2 years), but not for humeral shaft (8.9 vs 8.5 years). For females, proximal humerus fractures occurred mainly in the 70–79 and 80+ years age groups, whereas humeral shaft fractures followed a U-shaped pattern. Males showed a U-shaped pattern for both proximal humerus and humeral shaft fractures. Overall age-standardised incidence rates for proximal humerus fractures in males and females were 40.6 (95 % CI 32.7, 48.5) and 73.2 (95 % CI 62.2, 84.1) per 100,000 person years, respectively. For humeral shaft fractures, the age-standardised rate was 69.3 (95 % CI 59.0, 79.6) for males and 61.5 (95 % CI 51.9, 71.0) for females. There was an increase in risk of proximal humerus fractures in men with a lower femoral neck BMD, younger age, prior fracture and higher milk consumption. In pre-menopausal women, increased height and falls were both risk factors for proximal humerus fractures. For post-menopausal women, risk factors associated with proximal humerus fractures included a lower non-milk dairy consumption and sustaining a prior fracture. Humeral shaft fractures in both sexes were sustained mainly in childhood, while proximal humerus fractures were sustained in older adulthood. The overall age-standardised rates of proximal humerus fractures were nearly twice as high in females compared to males, whereas the incidence rates of humeral shaft fractures were similar.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hirzinger C, Tauber M, Resch PDH (2011) Die Fraktur des proximalen humerus [Fractures of the proximal humerus]. Der Unfallchirurg [The Trauma Surgeon] 114:1051–1058

    CAS  Google Scholar 

  2. Lee SH, Dargent-Molina P, Bréart G (2002) Risk factors for fractures of the proximal humerus: results from the EPIDOS prospective study. J Bone Miner Res 17:817–825

    Article  PubMed  Google Scholar 

  3. Maravic M, Briot K, Roux C (2014) Burden of proximal humerus fractures in the French National Hospital Database. Orthop Traumatol 100:931–934

    CAS  Google Scholar 

  4. Roux A, Decroocq L, Batti SE, Bonnevialle N, Moineau G, Trojani C, Boileau P, Peretti Fd (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol 98:715–719

    CAS  Google Scholar 

  5. Charissoux J-L, Vergnenegre G, Pelissier M, Fabre T, Mansat P (2013) Epidemiology of distal humerus fractures in the elderly. Orthop Traumatol 99:765–769

    Google Scholar 

  6. Palvanen M, Kannus P, Niemi S, Parkkari J (2010) Secular trends in distal humeral fractures of elderly women: Nationwide statistics in Finland between 1970 and 2007. Bone 46:1355–1358

    Article  PubMed  Google Scholar 

  7. Min W, Anwar A, Ding BC, Tejwani NC (2010) Open distal Humérus fractures: review of the literature. Bull Hosp Jt Dis 68:257-261

    Google Scholar 

  8. Chu SP, Kelsey JL, Keegan THM, Sternfeld B, Prill M, Quesenberry CP, Sidney S (2004) Risk factors for proximal humerus fracture. Am J Epidemiol 160:360–367

    Article  PubMed  Google Scholar 

  9. Clement ND, Duckworth AD, McQueen MM, Court-Brown CM (2014) The outcome of proximal humeral fractures in the elderly: predictors of mortality and function. Bone Jt J 96-B:970-977

    Article  CAS  Google Scholar 

  10. Kannus P, Palvanen M, Niemi S, Sievänen H, Parkkari J (2009) Rate of proximal humeral fractures in older Finnish women between 1970 and 2007. Bone 44:656–659

    Article  PubMed  Google Scholar 

  11. Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, Thaler H, Szivak M, Amrein K, Borgström F (2013) Epidemiology of proximal humeral fractures in Austria between 1989 and 2008. Osteoporos Int 24:2413–2421

    Article  CAS  PubMed  Google Scholar 

  12. Watts JJ, Abimanyi-Ochom J, Sanders KM (2013) Osteoporosis costing all Australians A new burden of disease analysis—2012 to 2022. Osteoporosis Australia. http://apo.org.au/node/37062

  13. Abimanyi-Ochom J, Watts JJ, Borgström F, Nicholson GC, Shore-Lorenti C, Stuart AL, Zhang Y, Iuliano S, Seeman E, Prince R, March L, Cross M, Winzenberg T, Laslett LL, Duque G, Ebeling PR, Sanders KM (2015) Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS). Osteoporos Int 26:1781–1790

  14. Huttunen TT, Launonen AP, Pihlajamäki H, Kannus P, Mattila VM (2012) Trends in the surgical treatment of proximal humeral fractures: a nationwide 23-year study in Finland. BMC Musculoskeletal Disorders 13:261

    Article  PubMed Central  PubMed  Google Scholar 

  15. Pasco JA, Nicholson GC, Henry MJ, Kotowicz MA, Gaudry TM (1999) Identification of incident fractures: the Geelong osteoporosis study. Aust N Z J Med 29:203–206

    Article  CAS  PubMed  Google Scholar 

  16. Pasco JA, Nicholson GC, Kotowicz MA (2012) Cohort profile: Geelong osteoporosis study. Int J Epidemiol 41:1565–1575

    Article  PubMed  Google Scholar 

  17. Centers for Disease Control and Prevention (2013) International Classification of Diseases, Ninth Revision (ICD-9)

  18. Australian Bureau of Statistics (2006) Census Community Profile Series (catalogue number 2001.0)

  19. Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247

    Article  CAS  PubMed  Google Scholar 

  20. Hill K, Schwarz J (2004) Assessment and management of falls in older people. Intern Med J 34:557–564

    Article  CAS  PubMed  Google Scholar 

  21. Sanders KM, Nicholson GC, Ugoni AM, Pasco JA, Seeman E, Kotowicz MA (1999) Health burden of hip and other fractures in Australia beyond 2000. Med J Aust 170:467–470

    CAS  PubMed  Google Scholar 

  22. Palvanen M, Kannus P, Parkkari J, Pitkäjärvi T, Pasanen M, Vuori I, Järvinen M (2000) The injury mechanisms of osteoporotic upper extremity fractures among older adults: a controlled study of 287 consecutive patients and their 108 controls. Osteoporos Int 11:822–831

    Article  CAS  PubMed  Google Scholar 

  23. Olsson C, Nordqvist A, Petersson CJ (2004) Increased fragility in patients with fracture of the proximal humerus: a case control study. Bone 34:1072–1077

    Article  CAS  PubMed  Google Scholar 

  24. Holloway KL, Brennan SL, Kotowicz MA, Bucki-Smith G, Timney EN, Dobbins AG, Williams LJ, Pasco JA (2015) Prior fracture as a risk factor for future fracture in an Australian cohort. Osteoporos Int 26:629–635

    Article  CAS  PubMed  Google Scholar 

  25. Michaëlsson K, Wolk A, Langenskiöld S, Basu S, Lemming EW, Melhus H, Byberg L (2014) Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ 349:g6015

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by the National Health and Medical Research Council (NHMRC) Australia (Project 628582), the Geelong Regional Medical Foundation, Arthritis Foundation of Australia, Perpetual Trustees, and Amgen Europe (GmBH); however, the funding bodies played no part in the design or conduct of the study, the collection, management, analysis and interpretation of the data, nor in the preparation or review of the manuscript. Sharon L. Brennan-Olsen is supported by an Alfred Deakin Postdoctoral Fellowship (2015–2016).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kara L. Holloway.

Ethics declarations

Conflict of interest

Kara L. Holloway, Gosia Bucki-Smith, Amelia G. Morse, Sharon L Brennan-Olsen, Mark A. Kotowicz, David J. Moloney, Kerrie M. Sanders, Sam Korn, Elizabeth N. Timney, Amelia G. Dobbins and Julie A. Pasco these authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This study was approved by the Barwon Health Human Research Ethics Committee. Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holloway, K.L., Bucki-Smith, G., Morse, A.G. et al. Humeral Fractures in South-Eastern Australia: Epidemiology and Risk Factors. Calcif Tissue Int 97, 453–465 (2015). https://doi.org/10.1007/s00223-015-0039-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00223-015-0039-9

Keywords

Navigation