Epidemiology and Incidence of Upper Limb Fractures: A UK Level 1 Trauma Center Perspective.

Abstract

Introduction Understanding the incidence and epidemiology can inform clinicians and policymakers about the population's needs. Our study reports on upper limb fractures treated at a major trauma center over 7.5 years. Methods We collected data on fracture locations, age, gender, Charlson Comorbidity index (CCI), and treatment options of all upper limb fractures treated at a Level I Trauma Centre fromJanuary 1, 2015 to June 30, 2022. Humerus, radius, and ulna fractures were each classified as proximal, diaphyseal, and distal. Results About 9,915 patients sustained 12,790 fractures, given an overall incidence of 303.2 fractures per 100,000 patients per year. The most common fracture site was the distal radius (60.1 fractures per 100,000 patients per year, whereas carpal and metacarpal bones had the lowest incidence. The mean age and CCI were 46.4 years and 1.54, respectively. 58.1% of patients were male. All bone fractures distal to the elbow were associated with an age younger than the mean (all p<0.001), with humerus fracture patients having the oldest mean age (54.6 years). Compared to the mean gender ratio, except for ulna (no association), humerus (55% female), and radius (51% female), all other locations showed significantly higher incidences of males (all p<0.001). When plotting the incidence based on the age of injury, the entire cohort, along with radius and ulna fracture subgroups, demonstrated a bi-peak distribution. This pattern revealed that younger males and older postmenopausal females had the highest incidence rates. Conclusion To our knowledge, this represents the first study of this type in the UK since 2006. We sought to elucidate relative incidence and demographic associations with fractures to highlight changing population needs and allow policymakers and services at a regional and national level to operate with up-to-date information.