Social deprivation influences the epidemiology and outcome of proximal humeral fractures in adults for a defined urban population of Scotland.
We present the epidemiology and incidence of proximal humeral fractures over a 17-year period for a defined urban population that represents approximately 13% of the population in Scotland, and functional outcome in relation to the socio-economic status of the patient. The incidence of proximal humeral fractures significantly increased during the study period from 47.9/10(5)/year to 98.7/10(5)/year in 2008 (p < 0.0001), which was greatest for the most socially deprived patients reaching 274.2/10(5)/year in 2008 (p < 0.0001). The most deprived patients sustained their fracture 4 years earlier than the most affluent patients (p = 0.026). Social deprivation was an independent predictor, after adjusting for other confounding variables using multivariable regression analysis, of a significantly worse functional outcome according to the Constant score at 1 year (p = 0.046). Preventative measures, especially for the most socially deprived patients within society, need to be instigated urgently to address the increasing incidence of proximal humeral fractures and alleviate the burden of these morbid fractures in the future. Whether the observed increased incidence is generalisable to a national population would need to be confirmed in future studies.
Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK, nickclement@doctors.org.uk.
N D
ND
Clement
M M
MM
McQueen
C M
CM
Court-Brown
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty; D020127:Recovery of Function; D012606:Scotland / Q000453:epidemiology; D012782:Shoulder / Q000503:physiopathology; D012784:Shoulder Fractures / Q000453:epidemiology* / Q000517:prevention & control; D012923:Social Class; D014505:Urban Population / Q000706:statistics & numerical data*