Rising burden of upper extremity fractures in China (1990–2021): A national study linking falls, aging, and divergent global trends

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-10-04 DOI:10.1016/j.injury.2025.112783

Vidmi Taolam Martin, Shao-Yong Xu, Bin Yu

{"title":"Rising burden of upper extremity fractures in China (1990–2021): A national study linking falls, aging, and divergent global trends","authors":"Vidmi Taolam Martin, Shao-Yong Xu, Bin Yu","doi":"10.1016/j.injury.2025.112783","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Upper extremity fractures (UEFs) are a growing public health concern in China, yet comprehensive epidemiological data remain limited. This study examines the burden, trends, and risk factors of UEFs in China from 1990 to 2021.</div></div><div><h3>Methods</h3><div>Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed the incidence, years lived with disability (YLDs), and causes of UEFs in China. Age-standardized rates (ASRs) were calculated, and trends were assessed using regression models. Sociodemographic index (SDI) associations and global comparisons were evaluated.</div></div><div><h3>Results</h3><div>In 2021, China recorded 11.1 million new UEF cases, a 31.92% increase since 1990. The age-standardized incidence rate (ASIR) rose by 7.97%, contrasting with a 20.92% global decline. Fractures of the radius and/or ulna had the highest ASIR (404.52 per 100,000), while shoulder fractures saw the steepest YLD increase (42.69%). UEFs were more prevalent in males, except among children (<1, 10–14 years) and older adults (≥65 years), where females predominated. Falls accounted for 72.98% of UEFs, followed by road injuries (13.38%). Rehabilitation needs (YLDs) grew by 32.28%, with SDI-linked trends showing a plateau at SDI 0.59–0.72.</div></div><div><h3>Conclusions</h3><div>China's increasing burden of UEF, influenced by factors such as falls, an aging population, and urbanization, contrasts with the global downward trends. Immediate targeted actions (implementing fall prevention strategies for the elderly, enhancing road safety for young people, and broadening access to rehabilitation services) are essential to address this escalating public health issue.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 12","pages":"Article 112783"},"PeriodicalIF":2.0000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury-International Journal of the Care of the Injured","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020138325006412","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Upper extremity fractures (UEFs) are a growing public health concern in China, yet comprehensive epidemiological data remain limited. This study examines the burden, trends, and risk factors of UEFs in China from 1990 to 2021.

Methods

Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed the incidence, years lived with disability (YLDs), and causes of UEFs in China. Age-standardized rates (ASRs) were calculated, and trends were assessed using regression models. Sociodemographic index (SDI) associations and global comparisons were evaluated.

Results

In 2021, China recorded 11.1 million new UEF cases, a 31.92% increase since 1990. The age-standardized incidence rate (ASIR) rose by 7.97%, contrasting with a 20.92% global decline. Fractures of the radius and/or ulna had the highest ASIR (404.52 per 100,000), while shoulder fractures saw the steepest YLD increase (42.69%). UEFs were more prevalent in males, except among children (<1, 10–14 years) and older adults (≥65 years), where females predominated. Falls accounted for 72.98% of UEFs, followed by road injuries (13.38%). Rehabilitation needs (YLDs) grew by 32.28%, with SDI-linked trends showing a plateau at SDI 0.59–0.72.

Conclusions

China's increasing burden of UEF, influenced by factors such as falls, an aging population, and urbanization, contrasts with the global downward trends. Immediate targeted actions (implementing fall prevention strategies for the elderly, enhancing road safety for young people, and broadening access to rehabilitation services) are essential to address this escalating public health issue.

查看原文本刊更多论文

中国上肢骨折负担增加（1990-2021）：一项将跌倒、老龄化和不同的全球趋势联系起来的全国性研究

在中国，下肢骨折（UEFs）是一个日益受到关注的公共卫生问题，但全面的流行病学数据仍然有限。本研究考察了1990 - 2021年中国UEFs的负担、趋势和危险因素。方法利用全球疾病负担（GBD） 2021研究的数据，分析中国UEFs的发病率、残疾生活年限（YLDs）和原因。计算年龄标准化率（ASRs），并使用回归模型评估趋势。评估了社会人口指数（SDI）的相关性和全球比较。结果2021年，中国新增UEF病例1110万例，较1990年增长31.92%。年龄标准化发病率（ASIR）上升了7.97%，而全球下降了20.92%。桡骨和/或尺骨骨折的ASIR最高（404.52 / 100,000），而肩部骨折的YLD增幅最大（42.69%）。UEFs在男性中更为普遍，但在儿童（10-14岁）和老年人（≥65岁）中以女性为主。跌倒占uef的72.98%，其次是道路伤害（13.38%）。康复需求（YLDs）增长了32.28%，与SDI相关的趋势在SDI 0.59-0.72处趋于稳定。结论受摔伤、人口老龄化和城市化等因素的影响，中国UEF负担的增加与全球下降趋势形成鲜明对比。要解决这一日益严重的公共卫生问题，必须立即采取有针对性的行动（实施老年人预防跌倒战略，加强年轻人的道路安全，扩大获得康复服务的机会）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.