• Daniele Passaretti, Vittorio Candela, Pasquale Sessa, and Stefano Gumina.
• Shoulder and Elbow Unit, Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome-Policlinico Umberto I, Rome, Italy. Electronic address: passaretti.md@gmail.com.
• J Shoulder Elbow Surg. 2017 Dec 1; 26 (12): 2117-2124.

BackgroundLiterature lacks data concerning several epidemiologic aspects of proximal humeral fractures (PHFs).MethodsThis retrospective study included 711 consecutive patients (209 men, 502 women) who sustained a PHF in the last 3 years. Participants were divided into 2 groups, adults and children. Data regarding age, sex, date, and fracture side were collected. According to the mechanism of injury, we arbitrarily distinguished 7 subgroups. PHFs were classified according to the head-greater-lesser-shaft (HGLS)-Hertel classification and to the Salter-Harris classification using x-ray and computed tomography imaging.ResultsPHFs represent 5.03% of the overall fractures. The right side was involved in 389 patients (54.7%; P = .6). The mean age of male and female patients was 55.4 (standard deviation,  21.9) years and 67.0 (standard deviation, 16.1) years, respectively (P = .0001). Significant differences in the trauma mechanism between female patients (street/home low-energy trauma) and male patients (high-energy trauma) were found. A significant correlation between trauma mechanisms from 1 to 5 and fracture patterns H-G-L-S, HL-G-S, HGL-S, and HLS-G was observed. The occurrence of the same patterns significantly varied according to different age subgroups. Considering the pediatric population, a significant incidence of Salter-Harris 2 in both genders was found. No correlation was observed between the fracture patterns and the trauma mechanism.ConclusionsPHFs have a higher prevalence and incidence in females and in older age, respectively; they are more frequent in the winter months. In addition, male fractures are due to different traumatic events than those in females. A correlation between trauma and PHF pattern was evident only for adults. Some fracture patterns are correlated with different ranges of age in all patients.Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

29 keywords...

hide…