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

Overview

Journal J Bone Metab

Date 2019 Jun 22

PMID 31223607

Citations 14

Authors

Hyoung-Seok Jung

Jae-Hwi Nho

Yong-Chan Ha

Sunmee Jang

Ha-Young Kim

Jun-Il Yoo

Sang-Min Park

Young-Kyun Lee

Affiliations

Soon will be listed here.

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.

Citing Articles

Association between antibiotics use and osteoporotic fracture risk: a nationally representative retrospective cohort study.

Lee J, Park S, Park Y, Jeong S, Song J, Kim H Arch Osteoporos. 2024; 19(1):81.

PMID: 39212806 PMC: 11364706. DOI: 10.1007/s11657-024-01438-8.

Wang Y, Li J, Men Y, Wei W Orthop Surg. 2024; 16(10):2509-2516.

PMID: 39117579 PMC: 11456710. DOI: 10.1111/os.14186.

Association between Deltoid Muscle Density and Proximal Humeral Fracture in Elderly Patients.

Liang Y, Yang L, Zhang J, Hu J, He J, Chen P Orthop Rev (Pavia). 2024; 16:94103.

PMID: 38974660 PMC: 11224064. DOI: 10.52965/001c.94103.

Sodium-Glucose Cotransporter 2 Inhibitors vs Incretin-Based Drugs and Risk of Fractures for Type 2 Diabetes.

Ko H, Bea S, Jeong H, Park S, Cho Y, Kong S JAMA Netw Open. 2023; 6(9):e2335797.

PMID: 37751205 PMC: 10523172. DOI: 10.1001/jamanetworkopen.2023.35797.

Age- and dose-dependent effect of statin use on the risk of osteoporotic fracture in older adults.

Seo D, Jeong Y, Cho Y, Kim S, Hong S, Suh Y Osteoporos Int. 2023; 34(11):1927-1936.

PMID: 37552294 DOI: 10.1007/s00198-023-06879-4.

References

Klotzbuecher C, Ross P, Landsman P, Abbott 3rd T, Berger M . Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000; 15(4):721-39. DOI: 10.1359/jbmr.2000.15.4.721. View

Wu F, Mason B, Horne A, Ames R, Clearwater J, Liu M . Fractures between the ages of 20 and 50 years increase women's risk of subsequent fractures. Arch Intern Med. 2002; 162(1):33-6. DOI: 10.1001/archinte.162.1.33. View

Rozental T, Branas C, Bozentka D, Beredjiklian P . Survival among elderly patients after fractures of the distal radius. J Hand Surg Am. 2002; 27(6):948-52. DOI: 10.1053/jhsu.2002.36995. View

Johnell O, Kanis J, Oden A, Sernbo I, Redlund-Johnell I, Petterson C . Fracture risk following an osteoporotic fracture. Osteoporos Int. 2003; 15(3):175-9. DOI: 10.1007/s00198-003-1514-0. View

Center J, Bliuc D, Nguyen T, Eisman J . Risk of subsequent fracture after low-trauma fracture in men and women. JAMA. 2007; 297(4):387-94. DOI: 10.1001/jama.297.4.387. View

Dennison E, Mohamed M, Cooper C . Epidemiology of osteoporosis. Rheum Dis Clin North Am. 2007; 32(4):617-29. DOI: 10.1016/j.rdc.2006.08.003. View

Lefevre-Colau M, Babinet A, Fayad F, Fermanian J, Anract P, Roren A . Immediate mobilization compared with conventional immobilization for the impacted nonoperatively treated proximal humeral fracture. A randomized controlled trial. J Bone Joint Surg Am. 2007; 89(12):2582-90. DOI: 10.2106/JBJS.F.01419. View

Bliuc D, Nguyen N, Milch V, Nguyen T, Eisman J, Center J . Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009; 301(5):513-21. DOI: 10.1001/jama.2009.50. View

Clinton J, Franta A, Polissar N, Neradilek B, Mounce D, Fink H . Proximal humeral fracture as a risk factor for subsequent hip fractures. J Bone Joint Surg Am. 2009; 91(3):503-11. PMC: 2669747. DOI: 10.2106/JBJS.G.01529. View

10.

Tarantino U, Capone A, Planta M, DArienzo M, Letizia Mauro G, Impagliazzo A . The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study. Arthritis Res Ther. 2010; 12(6):R226. PMC: 3046539. DOI: 10.1186/ar3213. View

11.

Calvo E, Morcillo D, Foruria A, Redondo-Santamaria E, Osorio-Picorne F, Caeiro J . Nondisplaced proximal humeral fractures: high incidence among outpatient-treated osteoporotic fractures and severe impact on upper extremity function and patient subjective health perception. J Shoulder Elbow Surg. 2011; 20(5):795-801. DOI: 10.1016/j.jse.2010.09.008. View

12.

Ruan W, Wang P, Ma X, Ge R, Zhou X . Analysis on the risk factors of second fracture in osteoporosis-related fractures. Chin J Traumatol. 2011; 14(2):74-8. View

13.

Bliuc D, Nguyen N, Nguyen T, Eisman J, Center J . Compound risk of high mortality following osteoporotic fracture and refracture in elderly women and men. J Bone Miner Res. 2013; 28(11):2317-24. DOI: 10.1002/jbmr.1968. View

14.

Lee Y, Ha Y, Choi H, Jang S, Park C, Lim Y . Bisphosphonate use and subsequent hip fracture in South Korea. Osteoporos Int. 2013; 24(11):2887-92. DOI: 10.1007/s00198-013-2395-5. View

15.

Balasubramanian A, Tosi L, Lane J, Dirschl D, Ho P, OMalley C . Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009. J Bone Joint Surg Am. 2014; 96(7):e52. DOI: 10.2106/JBJS.L.01781. View

16.

Beraldi R, Masi L, Parri S, Partescano R, Brandi M . The role of the orthopaedic surgeon in the prevention of refracture in patients treated surgically for fragility hip and vertebral fracture. Clin Cases Miner Bone Metab. 2014; 11(1):31-5. PMC: 4064438. View

17.

Maravic M, Briot K, Roux C . Burden of proximal humerus fractures in the French National Hospital Database. Orthop Traumatol Surg Res. 2014; 100(8):931-4. DOI: 10.1016/j.otsr.2014.09.017. View

18.

Park C, Jang S, Lee A, Kim H, Beom Lee Y, Kim T . Incidence and mortality after proximal humerus fractures over 50 years of age in South Korea: national claim data from 2008 to 2012. J Bone Metab. 2015; 22(1):17-21. PMC: 4357632. DOI: 10.11005/jbm.2015.22.1.17. View

19.

Brozek W, Reichardt B, Zwerina J, Dimai H, Klaushofer K, Zwettler E . Antiresorptive therapy and risk of mortality and refracture in osteoporosis-related hip fracture: a nationwide study. Osteoporos Int. 2015; 27(1):387-96. DOI: 10.1007/s00198-015-3415-4. View

20.

Kwon G, Jang S, Lee A, Park C, Lee Y, Kim T . Incidence and Mortality after Distal Radius Fractures in Adults Aged 50 Years and Older in Korea. J Korean Med Sci. 2016; 31(4):630-4. PMC: 4810349. DOI: 10.3346/jkms.2016.31.4.630. View