No obvious time trend in proximal humeral fracture complexity : a cohort study from 1944 to 2020 in Malmö, Sweden.

Aims: The epidemiology of proximal humerus fractures (PHFs) has been described in terms of incidence, fracture complexity, and general time trends, but current literature on time trends in PHF complexity is limited. This study aims to explore possible time trends in PHF complexity and report the distribution of different types of PHF from January 1944 to December 2020.

Methods: The city of Malmö, Sweden, has one emergency hospital where acute fractures are treated, and radiographs have been saved for almost a century. One author reviewed and classified relevant radiological examinations in individuals aged ≥ 18 years with a PHF during 17 sample years from 1944 to 2020 in Malmö using the Neer and AO classifications.

Results: Of the 3,031 identified PHFs, 2,216 (73%) were sustained by women (mean age 69 years (SD 14)) and 815 (27%) by men (mean age 59 years (SD 17)). We saw no obvious time trend in fracture complexity overall, for men and women separately, or for different age groups. Fracture complexity according to AO was higher in older than younger age groups, which was true also with the Neer classification for women. However, for men, according to the Neer classification, the fracture complexity was higher in younger than older age groups.

Conclusion: We found no obvious time trend in fracture complexity with the Neer or AO classification systems from 1944 to 2020.