The epidemiology of fractures around the elbow joint

Abstract

Background: The epidemiology of fractures of the distal humerus, proximal ulna and proximal radius has been individually studied. We sought to determine the epidemiological characteristics of all adult elbow fractures in our region, and look specifically for a relationship between their incidence and socioeconomic deprivation. Methods: We analyzed a prospectively collected trauma database from an institution serving a population of 545,000 adults. The demographic, injury and deprivation details for all patients suffering acute fractures of the distal humerus, proximal radius or proximal ulna were analyzed. Fractures were classified according to the AO, Mayo, Regan and Morrey, and modified Mason systems. Deprivation status was determined by using the Index of Multiple Deprivation. Results: We identified 405 elbow fractures in 382 patients, with an incidence of 7.4/10,000/yr. The incidence was higher in women, particularly in the elderly. In men the distribution was bimodal. Distal humerus, proximal ulna and proximal radius fractures displayed distinct epidemiological characteristics. A correlation was identified between increasing proximal forearm fracture incidence with increasing levels of deprivation. Conclusion: This report documents the current age-related incidence of these injuries and adds to the growing body of evidence that socioeconomic status influences the rate and patterns of skeletal injury in adults. Future work should examine whether the epidemiological characteristics of these injuries continue to change as our population demographics evolve over time