Proximal humeral fracture osteosynthesis in Belgium: a retrospective population-based epidemiologic study
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ORIGINAL ARTICLE
Proximal humeral fracture osteosynthesis in Belgium: a retrospective population‑based epidemiologic study Jan Dauwe1,2 · Carolin Danker1 · Michiel Herteleer3 · Kris Vanhaecht4 · Stefaan Nijs3 Received: 7 May 2020 / Accepted: 13 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Proximal humeral fractures (PHF) comprise approximately five percent of all fractures and this percentage will continue to increase due to the aging population with accompanying osteoporosis. Most PHF can be treated conservatively; however, in displaced fractures, surgical treatment is recommended. Retrospective analyses of large groups or even populations are important as they can contribute to the needs of the community. The aim of this study was to assess the epidemiology and management of PHF fixation in Belgium based on the most recently available data from the last 5 years. Methods The governmental organization National Institute of Health and Disability Insurance provided a population-based database with all PHF treated surgically or nonoperatively. This database was retrospectively assessed. The data included age, sex, region of residence, year and treatment strategy for every patient. Healthcare expenses were also provided. Results A total of 62,290 PHF were identified in Belgium between 2014 and 2018. The incidence was 111 per 100,000 persons/year. The highest incidence was observed in females and people older than 80 years. The average proportion of osteosynthesis was calculated at 21%. The Belgian government spent on average more than two million euros each year on PHF treatment. Conclusion The overall incidence of PHF increased by 12% over the last 5 years. The majority were treated nonoperatively in Belgium. Keywords Proximal humerus · Fracture · Epidemiology · Belgium · Healthcare
Introduction According to the most recent data from 2018, Belgium is number nine on the list of OECD (Organization for Economic Co-Operation and Development) countries, spending 10.4% of their GDP (Gross Domestic Product) on healthcare expenses [1]. Musculoskeletal conditions (including trauma) are the most common causes of physical disability and represent an enormous socio-economic cost [2]. Proximal
* Jan Dauwe [email protected] 1
AO Research Institute Davos, Davos, Switzerland
2
Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
3
Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium
4
LIHP, Leuven Institute for Healthcare Policy, Leuven, Belgium
humeral fractures (PHF) currently account for approximately five percent of all fractures [3] with an incidence of approximately 66–83/100,000 person/year worldwide [4–7]. The incidence increases in both male and female patients older than 50 years but escalates four times faster in women. The highest incidence is found in women aged 80–89 years. These trends were not only present in Europe, but also in the United States [8, 9]. The number of PHF will continue to increase
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