title: Humeral fractures due to low-energy trauma: an epidemiological survey in patients referred to a large emergency department in Northern Italy.
abstract: This survey describes the epidemiology of approximately 1800 low-energy humeral fractures seen in a large emergency department in Northern Italy over 7 years (2007-2013), highlighting the differences from previous Italian studies.
  
  
  OBJECTIVE
  The purpose of this study was to determine the incidence of humeral fractures due to low-energy trauma in patients 40 years of age or older referred to a large Emergency Department (Parma, Northern Italy) in a 7-year period (2007-2013).
  
  
  METHODS
  All humeral fractures referred to the emergency department of the Academic Hospital of Parma (the main hospital in the province with a catchment area of approximately 345,000) were retrieved from the hospital database using both ICD-9CM codes and text strings. The diagnosis of humeral fracture due to low-energy trauma was confirmed by medical records and X-ray reports, after exclusion of injuries due to a clear-cut high-energy trauma or cancer.
  
  
  RESULTS
  The query identified 1843 humeral fractures (1809 first fractures), with a clear predominance in women (78 %). Fractures of the proximal humerus represented the large majority of humeral fractures (more than 85 %), with an incidence progressively increasing with age (more than 60-fold in women and 20-fold in men). Simultaneous fractures (hip in particular) were frequent especially after 85 years of age (1 out of 8 cases). When compared to other Italian studies, the incidence of humeral fractures was significantly lower than that derived from discharge data corrected for hospitalization rate (standardized rate ratio 0.74; p < 0.001), while the pattern of age-related changes was significantly different from that computed by applying the ratio between hip and humeral fractures observed in Malmö, Sweden, to the Italian hip fracture rates.
  
  
  CONCLUSIONS
  This study gives an up-to-date description of the epidemiology of low-energy humeral fractures in Italy. Our results partly differ from previous Italian studies based on indirect estimations.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci 14, 43126, Parma, Italy, mario.pedrazzoni@unipr.it.
authors.forename: M
authors.initials: M
authors.lastname: Pedrazzoni
authors.forename: B
authors.initials: B
authors.lastname: Abbate
authors.forename: I
authors.initials: I
authors.lastname: Verzicco
authors.forename: A
authors.initials: A
authors.lastname: Pedrazzini
authors.forename: M
authors.initials: M
authors.lastname: Benatti
authors.forename: G
authors.initials: G
authors.lastname: Cervellin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006810:Humeral Fractures / Q000453:epidemiology* / Q000209:etiology; D006811:Humerus / Q000293:injuries*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors