The epidemiology of multifocal upper limb fractures

Aim: The aim of this study is to identify the epidemiology of multifocal upper limb fractures and define any commonly occurring patterns. Patients: Patients included were those over the age of 13 years who presented to one orthopaedic trauma unit, in an eight-year period, and who sustained a multifocal upper limb fracture. Results: There were 83 patients with 171 multifocal upper limb fractures. Mean age 60 years; range 13 to 80 years. 78 patients had bifocal fractures and 5 had trifocal. The most common pairing of fourteen different combinations was distal radius and proximal humerus. All but nine patients had involvement of the proximal humerus or distal radius. The most common injuries were the two-part proximal humerus fracture, the simple intra-articular olecranon fracture and the extra-articular fracture of the distal radius with metaphyseal comminution. Conclusion: This study has shown that multifocal fractures of the upper limb are most likely to occur in the middle aged to elderly women who have had a fall from standing height. As previously demonstrated osteopenic fractures are increasing in incidence in developed countries, where the population is ageing, which implies that the incidence of multifocal fractures of the upper limb is likely to increase.