J Bone Metab.  2019 May;26(2):105-111. 10.11005/jbm.2019.26.2.105.

Incidence of Osteoporotic Refractures Following Proximal Humerus Fractures in Adults Aged 50 Years and Older in Korea

Affiliations
  • 1Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 2Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 3College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
  • 4Division of Endocrinology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
  • 5Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
  • 6Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. ykleemd@gmail.com

Abstract

BACKGROUND
The purpose of this study was to investigate the incidence and characteristics of osteoporotic refractures after proximal humerus fracture in Korean adults aged above 50 years.
METHODS
Patients aged 50 years or older with initial proximal humerus fractures reported in 2012 were enrolled and followed up until 2016 using the Korean National Health Insurance data. Based on the last claim date, the refractures were classified as osteoporotic fractures including spine, hip, distal radius, and humerus 6 months after the index fracture involving the proximal humerus. Each osteoprotic fracture was identified using specific International Classification of Diseases, 10th Revision codes and site-specific physician claims for procedures.
RESULTS
A total of 5,587 first-time fractures involving proximal humerus were reported in 2012. Among them, a total of 1,018 osteoporotic refractures occured between 2012 and 2016. The total cumulative incidence of osteoporotic refractures was 4.85% (271/5,587) at 1 year, 9.61% (537/5,587) at 2 years, 14.21% (794/5,587) at 3 years, and 18.22% (1,018/5,587) at 4 years. In terms of site by year, the incidence of associated refractures was as follows: spine, 48.62% (495/1,018); hip, 25.83% (263/1,018); wrist 18.57% (189/1,018); and humerus 6.97% (71/1,018) during all the follow-up periods.
CONCLUSIONS
Our study showed that the cumulative incidence of osteoporotic refractures following proximal humerus fractures in the elderly population has been increasing over the years. Given that osteoporotic refractures are associated with an increased mortality risk, a public health strategy to prevent the refracture after proximal humerus fracture in the elderly is imperative.

Keyword

Humeral fractures; Osteoporotic fractures; Refracture

MeSH Terms

Adult*
Aged
Follow-Up Studies
Hip
Humans
Humeral Fractures
Humerus*
Incidence*
International Classification of Diseases
Korea*
Mortality
National Health Programs
Osteoporotic Fractures
Public Health
Radius
Spine
Wrist

Figure

  • Fig. 1 Flow chart of study subjects.

  • Fig. 2 (A) Cumulative incidence of osteoporotic refracture following proximal humerus fracture. (B) Cumulative incidence of second proximal humerus fracture.

  • Fig. 3 Proportion of location of osteroporotic refracture following proximal humerus fracture by year.


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