Fracture Incidence Rates Research Articles

The Incidence of Hip Fractures in the Study Population: A Retrospective Study

Introduction: Hip fractures can occur when the femoral neck, the region between the larger and lesser trochanters, or the area below the lesser trochanter breaks. Intertrochanteric fractures are extracapsular fractures of the proximal femur that occur between the greater and lesser trochanters. A subtrochanteric hip fracture occurs when a break between the region 5 cm below the lesser trochanter. Aim: To determine the incidence of hip fractures in the study population Methodology: This study comprised a total of 670 patients. There were 315 (47%) males and 355 (53%) females. The Proforma was created to record demographic information, hip fracture complications and lab test results. Every patient who was a part of this study gave their written informed permission. Before collecting data and publishing it in a medical publication, an ethics committee’s consent was obtained. The participants were chosen using a non-probability sequential selection approach. Results: The present studies show that higher numbers of hip fractures were observed in older age (above 66 years), in which 69% of females and 57% were males. The major cause of hip fracture was fall and slippage that broke the hip bone, it was found more in females (81.6%) than males (39.7%). Complications were observed due to waiting for their operative procedures. The delay has led to pulmonary, cardiac problems, and bedsores. However, in 80% of cases, the union of hip fracture was observed. Conclusion: The present study concluded that the incidence rate of hip fracture increases with respect to age. In males, a major cause of hip fracture was accidents Hip fractures are more prevalent in females, and fall and slippage are the major causes.

Association Between Landing Error Scoring System (LESS) Items and the Incidence Rate of Lower Extremity Stress Fracture

Association Between Landing Error Scoring System (LESS) Items and the Incidence Rate of Lower Extremity Stress Fracture

Secular trends in the incidence of fracture hospitalization between 2000 and 2015 among the middle-aged and elderly persons in Taiwan: A nationwide register-based cohort study.

Fractures are a common reason for hospital admissions. However, regional and short-term studies show a varying incidence rate (IR) of fractures, and most of the surveys were conducted from only a few medical centers. Therefore, this study aims to investigate the epidemiological data of fracture hospitalizations of middle-aged and elderly persons in Taiwan between 2000 and 2015. Data from fractures occurring between 2000 and 2015 were obtained from the National Health Insurance Research Database in Taiwan for this study. The IR of fracture admission in patients, aged 40years or older at the time of admission and first-time diagnosed with a fracture following admission, was calculated. We found that the IR of the fracture hospitalizations declined considerably from 95.70 per 10,000person-years in 2000, to 68.48 per 10,000person-years in 2015. The three most common fracture hospitalizations accounting for more than 50% of all fractures were fractures of the femur/hip, radius or ulna, and vertebral column. The IR of fracture hospitalization increased with age and was found to be higher in women than in men. The most common cause of fracture hospitalization for men and patients under 65years of age was traffic accidents. In contrast, falls were the most frequent causes of fracture hospitalization for women and patients over 65years of age. The present study furnishes an updated picture of the incidence of fracture hospitalization over a 16-year period among middle-aged and elderly persons in Taiwan.

Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations.

This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with “incidence,” and 387 results with “epidemiology,” of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.

Real-world treatment and fracture incidence in postmenopausal women with severe osteoporosis at high risk of fracture: a retrospective claims data analysis.

Background: Osteoporosis (OP) and its associated fractures have a significant impact on patients’ quality of life and are impacting their morbidity and mortality. For OP patients at high risk of fracture, guidelines recommend a pharmacological OP treatment. The aim of this study was to describe the real-world medication treatment of postmenopausal women with severe OP at high risk of fracture, their risk to experience a new fracture after having at least one previous fracture, and to assess the associated healthcare resource use (HCRU).Methods: This retrospective cohort study was based on anonymized German claims data (AOK PLUS). All included OP patients were female, ≥55 years old, and had a vertebral and/or femoral fracture. We conducted a cross-sectional analysis in 2018 and a longitudinal analysis, starting with an incident vertebral/femoral fracture (after or simultaneously with the first observed OP diagnosis). In both analyses, patient characteristics, rate of new incident fractures, OP treatment patterns, and HCRU associated with the treatment of patients were investigated.Results: In the cross-sectional setting, 12,180 patients with a mean age of 83.59 years were observed. Of these patients, 14.30% sustained at least one new incident fracture and 34.54% received a pharmaceutical OP treatment during 2018. In this year, 58.50% of the patients had at least one OP-related outpatient visit, and 26.35% had a fracture-related visit. In 160 patients (1.31%), at least one OP-related hospitalization was documented, and in 1,293 patients (10.62%) a fracture-related hospitalization in 2018.In the longitudinal setting, 10,323 patients with a mean age of 83.22 years were included. Of these, 18.96% experienced at least one new incident fracture within the first 12 months after the index fracture, and in total 30.85% in the entire follow-up period (mean 2.03 years). During the 12-month baseline period, 22.12% of the patients received an OP treatment. Three months after the index fracture, the proportion of treated patients remained at 22.30%. During the total follow-up time, 35.54% were prescribed with an OP treatment.Conclusion: We observed a considerable proportion of untreated patients and a high rate of subsequent fractures. The awareness for a proper risk assessment and the appropriate use of available treatments should be increased.

Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults.

ImportanceReliable evidence on modifiable risk factors for hip and major osteoporotic fractures in untreated populations could inform prevention strategies for hip fracture worldwide.ObjectivesTo estimate the age- and sex-specific incidence of hip, major osteoporotic and any fractures and examine their associated risk factors in Chinese adults.Design, Setting, and ParticipantsProspective study of 512,715 adults, aged 30-79 years, recruited for the China Kadoorie Biobank from 10 diverse areas in China in 2004-2008 and followed up for 10 years.ExposuresSociodemographic factors (e.g. age, sex, and education), medical history (e.g. CVD, diabetes, fracture, and rheumatoid arthritis), anthropometry (e.g. weight, waist-hip ratio) and lifestyle factors (e.g. smoking, alcohol drinking, physical activity, diet).Main Outcomes and MeasuresAge- and sex-specific incidence rates of fracture types, and adjusted hazard ratios (HR) and population attributable fractions (PAF) for individual risk factors associated with fracture types.ResultsThe incidence rates of hip fracture in Chinese adults were 5.1 (95%CI 5.0-5.3) per 10,000 person-years (2616 cases); and were higher in women than men (5.8 [5.5-6.1] vs 4.2 [3.9-4.5]) and increased by about 2 to 3-fold per 10 years older age. Among men, five risk factors for hip fracture including low education (HR=1.23; 95%CI 1.04-1.45), regular smoker (1.22, 1.03-1.45), lower weight (lowest vs other quintiles: 1.59, 1.34-1.88), alcohol drinker (1.18, 1.02-1.36), and prior fracture (1.62, 1.33-1.98) accounted for 44.3% of hip fractures. Among women, five risk factors including lower weight (lowest vs other quintiles: 1.30, 1.15-1.46), low physical activity (lowest vs other quintiles: 1.22, 1.10-1.35), diabetes (1.62, 1.41-1.86), prior fracture (1.54, 1.33-1.77), and self-rated poor health (1.29, 1.13-1.47), accounted for 24.9% of hip fractures. Associations of these risk factors with major osteoporotic (6857 cases) or any (15762 cases) fractures were weaker than those with hip fracture.ConclusionsThe age- and sex-specific incidence rates of hip fracture in Chinese adults were comparable with those in Western populations. Five potentially modifiable factors accounted for half of all hip fractures in men and one quarter in women.

Community-based Study on Hip Fracture in a Rural Area in Northeast Indiana

Background/Objective: There are few studies in the literature focused on rural hip fracture epidemiology, and fewer still that consider hip fractures at a specific county level or trauma center (TC) region. The aim of this study is to elucidate patterns of injury events and injury burden of hip fractures in a rural trauma center in northeast Indiana. 
 
 Patients and Measurements: We ascertained 2019 hip fracture cases that consisted of three sets of data, namely, emergency department visits (ED), hospitalizations (IP), and deaths from clinical databases. We analyzed the cases by fracture type, measured incidence rates (IRs) per 1,000 county residents and described the injury pattern of hip fractures by variables such as county of residence, age, and sex. We considered the mechanism of injury (cause) of the fractures as well as the injury burden based on the above three sets. 
 
 Results: A ratio of roughly 2:1 was found for extracapsular to intracapsular hip fractures. Injury patterns showed that the study counties had similar incidence rates with a range of 0.96 to 1.41 per 1,000 residents. Males and females ages 0-69 years had similar incidences of hip fracture. Overall, females had a 41% higher incidence rate of hip fractures than males. Injury burden indicated a similar distribution of ED to IP to mortality cases across the five study counties, and the majority (98.4%) of hip fractures with known causes of injury were due to falls. 
 
 Conclusions and Potential Impact: We elucidated the injury patterns and burden of hip fractures in a verified level II trauma center region. The results of this study have the potential benefit for the future development of hip fracture prevention programs for rural, elderly populations in northeast Indiana.

Do sandwich vertebral bodies increase the risk of post-augmentation fractures? A retrospective cohort study.

Sandwich vertebral bodies (SVBs) are intact unaugmented vertebral bodies between two previously augmented vertebrae. Until recently, only a few studies have reported the outcomes and strategies for SVBs. This retrospective cohort study aimed to describe the clinical features and incidence of new fractures in patients with SVBs. The clinical data were collected from 179 patients with 237 symptomatic osteoporotic vertebral compression fractures who underwent vertebral augmentation (VA). Among them, 23 patients with 24 levels of SVBs were included. Spinal radiographs (X-ray and CT) of all patients were evaluated prior to surgery 1 day after primary VA and during follow-up. All patients successfully underwent PKP with an average follow-up period of 21.48 months. Asymptomatic cement leakage occurred in four patients (17.4%), and eight patients (34.8%) developed new fractures following primary PKP, including four sandwich, six adjacent, four remote vertebral fractures, and one re-collapse of cemented vertebrae. The incidence of new fractures in the SVB and control groups was 16.7% (4/24) and 13.0% (6/46), respectively, but there was no significant difference. Although patients with SVBs had a relatively high risk of developing new fractures after VA, the incidence rate of new fractures was not significantly different from that of the control group. However, the statistical power of this study was very limited. Therefore, and because the refracture rate in these patients is substantial, routine long-term monitoring of patients after VA for osteoporosis is strongly recommended.

Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis

BackgroundOsteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran.MethodsA comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic.ResultsIn all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively.ConclusionThis study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model.

Associations between condylar fractures and external auditory canal fracture: A 7-year retrospective study

The study aimed to investigate whether the incidence rate of external auditory canal (EAC) fracture varies among different clinical types of condylar fracture. A retrospective cohort study was conducted in single hospital of China. Eligible patients diagnosed with mandibular condylar fractures were retrospectively reviewed. Among all patients with condylar fractures (318 cases and 437 sides), 45 cases and 59 sides (59/437 sides, 13.5%) were found with EAC fracture, including 17(17/38, 44.7%) sides of sagittal fracture of condyle (Type I), 21(21/59, 35.6%) sides of intracapsular condylar fracture (Type II), 8 (8/306, 2.6%) sides of condylar neck fracture (Type III), and 6 (6/34, 17.7%) sides of condylar base fracture (Type IV). Type III condylar fracture had a significant lower rate of EAC fracture than all other three types (all p<0.001). Type I condylar fracture had a higher rate of EAC fracture compared to Type IV (p=0.014). The incidence rates of EAC fracture in combined Type I+Type II group (38/97, 39.2%) was significantly higher than Type III (8/306,2.6%, p<0.001) and Type IV (6/34,17.7%, p=0.002). A total of 35 sides (27 patients) with combined fractures were followed up for 6 months after treatment, among whom 11 sides (7 patients) were operated for both fractures simultaneously. Neither EAC stenosis nor hearing loss was observed. Meanwhile, for 24 non-operated ears from 20 patients, all EACs showed different degrees of stenosis. In conclusion, oral and maxillofacial surgeons should pay more attention to EAC fracture combined with condylar fracture, especially for patients diagnosed with condylar head fracture. Maxillofacial fractures should be accompanied by early treatment of EAC fractures, in order to prevent EAC stenosis, hearing loss, and other complications.

Fracturas de cadera en pacientes tratados con fármacos antipsicóticos. Estudio de cohortes históricas en Cataluña

ObjectiveTo evaluate the incidence of hip fracture in patients with antipsychotic treatment, comparing it with that of individuals who have not been treated with antipsychotics. DesignRetrospective cohort study of patients treated with antipsychotic drugs (TAP) and patients without known treatment (non-TAP). The observation period was 2006–2014. SiteAll primary care teams in Catalonia of the Catalan Health Institute (ICS). ParticipantsPatients older than 44 years with TAP lasting at least 3 months. Control cohort: random selection of non-TAP patients matching for baseline comorbidities and other variables. A total of 22,010 are analyzed.Main measurements Incidence rate (1000× person-years: PY) of hip fracture in each group (TAP and non-TAP). Cox regression models to estimate adjusted risks (hazard ratio: HR). ResultsThe hip fracture incidence rate was higher in TAP patients (5.83 vs 3.58 fractures per 1000 PY), and is higher in all strata according to sex, age and type of diagnosis. The risk of suffering a hip fracture was 60% higher (HR: 1.60 95% CI: 1.34–1.92) in the TAP group than in the non-TAP group. The risk was higher in the group with schizophrenia (HR: 3.57 95% CI: 1.75–7.30), followed by bipolar disorder (HR: 2.61; 95% CI: 1.39–4.92) and depression (HR: 1.51; 95% CI: 1.21–1.88). ConclusionsPatients with antipsychotic treatment have a higher risk of hip fracture than those who have not been treated with antipsychotics.

Urban versus rural differences of hip fractures among the elderly in Kyoto, Japan: a 10-year study.

Our survey in Kyoto Prefecture from 2008 to 2017 showed that the incidence rate of femoral neck fractures is generally increasing. We investigated the differences between urban and rural areas in the changes of the incidence rate over time of femoral neck and trochanteric fractures during the same period. Patients aged 65years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The ratio of sick beds for acute-term care at the investigated hospitals to total number of beds in the urban area was 16.5% (1863/11,158) and 30.6% (1863/5623) in the rural area. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. There were 3559 and 6474 hip fractures in the urban and rural areas, respectively. Femoral neck fractures were 1936 (54.4%) and 2813 (43.5%) in each area. The increase of the population-adjusted numbers was marked by neck fractures in males, in both areas. In women, there was a significant increase in femoral neck fractures in the urban area in those aged 85years and over. For trochanteric fractures, a significant increase was only found in women aged 65 to 74years in the rural area. A regional difference in the secular changes in incidence rate of hip fractures was found in women, not in men, mostly because neck fractures in women increased in the over 85 group in the urban area.

Polypharmacy and bone fracture risk in patients with type 2 diabetes: The Fukuoka Diabetes Registry

AimsTo prospectively investigate the association between the number of prescribed drugs and the fracture risk in patients with type 2 diabetes. MethodsJapanese participants with type 2 diabetes (n = 4,706; 2,755 men, 1,951 postmenopausal women; mean age, 66 years) were followed for a median of 5.3 years and grouped on the basis of the number of prescribed drugs at baseline. The main outcomes were fractures at any anatomic site and fragility fractures (fractures at hip and spine sites). ResultsDuring follow-up, any fracture occurred in 662 participants. The overall age- and sex-adjusted fracture incidence rates per 1,000 person-years were 21.2 (0–2 drugs), 28.1 (3–5 drugs), 37.7 (6–8 drugs), and 44.0 (≥9 drugs) (p for trend < 0.001). Compared with 0–2 drugs, the multivariate-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for fractures were 1.34 (1.07–1.68) for 3–5 drugs, 1.76 (1.37–2.26) for 6–8 drugs, and 1.71 (1.27–2.31) in ≥ 9 drugs. The multivariate-adjusted HR (95% CI) per increment in drugs was 1.05 (1.02–1.08) (p < 0.001). Similar tendencies were observed for fragility fractures. ConclusionsA greater number of prescribed drugs is associated with an increased bone fracture risk in patients with type 2 diabetes.

380 To Change or Not to Change? Has COVID-19 Altered Our Adherence to BOAST Guidelines on Management of Ankle Fractures?

AimThe COVID-19 pandemic impacted the orthopaedic surgical ethos drastically. There was a lower threshold to manage fractures conservatively, in an attempt to curtail COVID-19 transmission rates amongst inpatients. This retrospective study evaluated our Orthopaedic department’s adherence to BOAST guidelines on ankle fractures, during COVID-19 and pre-COVID-19.MethodData on patient’s who presented with ankle fractures during the initial national lockdown in 2020 were compared against similar ankle fracture patterns one-year prior (pre-COVID) over a similar time frame. Patient clerking notes, operative notes, radiographical images and clinic letters were retrieved and compared against BOAST guidelines on ankle fractures. Management plans and time to surgery was extrapolated from these resources.ResultAnkle fracture incidence rates increased by 79.8% during the COVID pandemic when compared with data from 2019. 28% of ankle fractures in 2020 were managed operatively when compared with 80% in 2019. Average time to surgery during the pandemic improved by 1.64. Adequate documentation for neurovascular status, as per BOAST guidelines, was 30.5% in 2019 and 27% in 2020. Pre- and post-reduction views were available in 87% of cases in 2019 and 83% in 2020.ConclusionsAs a third national lockdown is upon us, evaluation of BOAST guidelines on ankle fractures would be worth revising. Teaching and posters were distributed throughout the department as a strategy to improve adherence to BOAST guidelines on ankle fractures. Furthermore, regular follow up clinics at specific times and post-management follow up clinics would be worth analysing to identify changes in patient satisfaction and clinical outcome.

The pattern of incident fractures according to fracture site in people with T1D.

People with T1D have a higher incidence of fractures compared to the general population. However, sparse knowledge exists on the incidence rates of individual fracture sites. Therefore, we examined the incidence of various fracture sites in people with newly treated T1D compared to matched controls. All people from the UK Clinical Practice Research Datalink GOLD (1987-2017), of all ages with a T1D diagnosis code (n = 6381), were included. People with T1D were matched by year of birth, sex, and practice to controls (n = 6381). Fracture IRs and incidence rate ratios (IRRs) were calculated. Analyses were stratified by fracture site and sex. The IR of all fractures was significantly higher in people with T1D compared to controls (IRR: 1.39 (CI95%: 1.24-1.55)). Compared to controls, the IRR for people with T1D was higher for several fracture sites including carpal (IRR: 1.41 (CI95%: 1.14-1.75)), clavicle (IRR: 2.10 (CI95%: 1.18-3.74)), foot (IRR: 1.70 (CI95%: 1.23-2.36)), humerus (IRR: 1.46 (CI95%: 1.04-2.05)), and tibia/fibula (IRR: 1.67 CI95%: 1.08-2.59)). In women with T1D, higher IRs were seen at the ankle (IRR: 2.25 (CI95%: 1.10-4.56)) and foot (IRR: 2.11 (CI95%: 1.27-3.50)), whereas in men with T1D, higher IRs were seen for carpal (IRR: 1.45 (CI95%: 1.14-1.86)), clavicle (IRR: 2.13 (CI95%: 1.13-4.02)), and humerus (IRR: 1.77 (CI95%: 1.10-2.83)) fractures. The incidence of carpal, clavicle, foot, humerus, and tibia/fibula fractures was higher in newly treated T1D, but there was no difference at other fracture sites compared to controls. Therefore, the higher incidence of fractures in newly treated people with T1D has been found mainly for distal fracture sites.

Incidence rate of osteoporotic hip fracture in Qatar

SummaryThe incidence rate of osteoporotic hip fracture is essential to formulate a national fracture risk assessment tool (FRAX). In this epidemiological study, the incidence rate of osteoporotic hip fracture in Qatar was comparable to that in regional countries, and lower than that in North America and European countries.PurposeEstimate the annual incidence rate (IR) of osteoporotic hip fractures (OHF) in Qatar from January 2017 to December 2019.MethodsHamad Medical Corporation is a government-based tertiary medical institute. Hip fractures were captured by using the International Classification of Diseases-10 hip fracture codes. The patient records were reviewed retrospectively to identify fracture mechanisms. The observed census in 2017 and the estimated censuses of 2018 and 2019 were used to calculate the age-sex-specific annual IR of OHF in the population aged ≥ 40 years. The world population in 2010 was used to calculate the age-adjusted standardized IR in the population aged ≥ 50 years.ResultsIn total, 458 hip fractures were identified; 75 (16.4%) were due to high-energy trauma, and 9 (2%) were pathological hip fractures. The total number of OHF was 374 (81.7%). OHF was slightly higher in men (215, 57.5%). The median age (IQR) of the patients was 69 years (56–78 years). In 2017, 2018, and 2019, the age-adjusted standardized IR of OHF per 100,000 with the corresponding 95% CI was 141.7 (141.1–142.2), 140.8 (140.2–141.3), and 162.7 (162.0–163.2) for the whole Qatar population; 154.2 (153.6–154.7), 105.2 (104.7–105.7), and 176.6 (175.9–177.1) for Qataris; and 134.8 (134.3–135.4), 183.9 (183.3–184.6), and 160.4 (159.8–161.0) for non-Qataris, respectively.ConclusionThe annual age-adjusted standardized IR of OHF per 100,000 inhabitants aged ≥ 50 years in Qatar was comparable to that in regional countries, and lower than that in North America and European countries.

A clinical study of proximal tibial condyle fracture treated by locking compression plate

AIMS and Objectives of the Study: The aim of the present study was to study the functional outcome and duration of union in proximal tibial fractures treated with Locking Compression Plate.Material and Methods: This study was a prospective study done on 26 consenting cases of proximal tibial fractures admitted to Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapur during October 2013 To August 2015 chosen based on the inclusion and exclusion criteria. Patients were informed about the study in all respects and written informed consent will be obtained. The follow up period was 6 weeks, 3months and 6months. Inclusive Criteria: All Schatzkers classification type I to VI proximal tibial fractures in adults Aged 18 years and above of either sex. Patients willing for treatment and giving informed and written consent. Exclusive Criteria Age group of less than 18 years. Patients not fit for surgery, managed conservatively for other medical reasons. All open fractures of proximal tibia. Patients with pathological proximal tibial fractures other than osteoporosis. Extraarticular fractures of proximal tibia. Sample Size: With an average incidence rate of proximal tibial fractures 1.75% [0.5 – 3%] at 95% confidence interval and + 5 margin of error the sample size is n=26. Hence 26 cases of proximal tibial fractures were included in the study.

National Electronic Injury Surveillance System sports-related arm fractures in the USA: thrower's fractures.

Humerus fractures are common in the USA. The purpose of this study was to utilize the National Electronic Injury Surveillance System: 1) to compare overall and age stratified incidence rates of proximal and distal arm fractures presenting to USA emergency departments; 2) to compare relative humerus fracture locations by age; and 3) to compare anatomical humerus fracture locations stratified by sports between 2005-2009 and 2015-2019. The National Electronic Injury Surveillance System was used to obtain estimated proximal and distal arm fractures between 2005-2009 and 2015-2019. Fracture rates were normalized using USA census estimates and stratified by age. Case summaries were filtered for anatomical and non-specific (proximal, middle, distal third) humerus fractures. Relative humerus fractures, inclusive of anatomical and non-specific fractures, were stratified by age and compared between 2005-2009 and 2015-2019. Anatomical fractures were stratified by sports. χ2 tests were used to compare fracture rates between time periods. There was a decrease (P<0.0001) in proximal and distal arm fracture rates and a difference (P<0.0001) in fracture rates with respect to age between 2005-2009 and 2015-2019. There was a significant difference in reported relative humeral fractures (P<0.0001) between the two periods. Impact related sports trauma accounted for most fracture cases for both periods. Non-impact related sports trauma consisted entirely of thrower's fractures. USA proximal and distal arm fracture rates decreased, and distributions differed by age between 2005-2009 and 2015-2019. Relative humerus fractures differed by time periods. One major non-impact sports related humerus fracture was extreme external rotational torque from throwing.

Sports-based distribution of facial fractures – findings from a four-season country

Objective The aim of this study was to elucidate the relationship between injury mechanisms and sports-related facial fractures, and to evaluate the changes in incidence rates of facial fractures sustained in sports-related events in a 30-year period. Material and methods This retrospective cohort study included all patients sports-related facial fractures admitted to a tertiary trauma centre during 2013–2018. Specific fracture types, sports, injury mechanisms as well as patient- and injury related variables are presented. The results underwent evaluated statistically with logistic regression analysis. Results Facial fractures occurred most frequently while playing ice hockey and football. Unilateral zygomatic-maxillary-orbital and isolated mandibular fractures accounted for 74.2% of all fracture types. In total, 99 patients (46.5%) required surgical intervention for their facial injuries. About 12.7% of patients sustained associated injuries in addition to facial fractures. Overall, the number of sports-related facial fractures has increased during the last three decades mostly due to the surging rates of ice hockey- and football-related facial fractures. Conclusions Sport-related facial fractures have markedly increased in different sports disciplines during the past decades. The use of safety gear to protect the facial area should be enforced particularly in ice hockey.

The incidence of fragility hip fractures in a subpopulation of South Africa

Background. Fragility hip fractures (FHFs) are associated with significant morbidity, mortality and burden on the healthcare system. European and North American literature suggests that the worldwide incidence of FHFs is increasing, but very little is known about the incidence of FHFs in Africa and South Africa (SA). Historically FHFs were believed to be uncommon in black African populations, but recent studies have shown a marked increase in the incidence compared with the early literature. Objectives. To investigate the age-, gender- and population group-specific incidences of FHFs in a subpopulation in Eastern Cape Province, SA. Methods. A retrospective review of all patients presenting with FHFs was performed at a tertiary hospital in the Eastern Cape over a 1-year period. Age-, gender- and population group-specific incidence rates were calculated for 5-year age intervals using the age distribution data of the western region of the Eastern Cape (WREC) as a denominator for each age group. Overall crude incidence rates were calculated by using the sum total of FHFs, divided by the study population. All incidences were calculated as number of fractures per 100 000 people annually. Results. A total of 253 patients with FHFs were included. The crude incidence rate of low-energy hip fractures in the WREC was 19.3 per 100 000 (males 14.6, females 23.4) over the study period. Population group-specific incidences were 15.1, 18.7, 19.9 and 46.6 per 100 000 for black, coloured, Indian and white population groups, respectively. The highest number of low-energy hip fractures in females occurred in the ≥85-year (19.6%) and 70 - 74-year (16.5%) age groups, with the highest number of male cases observed in the 60 - 64-year group (20.2%). The highest frequency distribution of FHFs was observed in black males aged 60 - 64 years (5.5%; n =14) and black females aged 70 - 74 years (6.3%; n =16). Conclusions. The local incidence of FHFs is higher than initially reported, but when compared with other countries remains on the lower end of spectrum. A large proportion of FHFs are occurring in young patients (<65 years). These findings warrant further investigation that may prompt the development of preventive strategies and optimal treatment programmes.