Lead Author(s): 

Jaimo Ahn, MD, PhD, FACS
Arvind D Nana, MD
Gudrun Mirick, MD
Anna N Miller, MD, FACS

Supporting Author(s): 

Sylvia I Watkins-Castillo, PhD

Fractures are one of the most common musculoskeletal injuries, and can have long-term impact, particularly among the elderly. In 2013, one in five (24%) musculoskeletal injuries treated in a healthcare facility was for a fracture, with 1 in 20 persons in the population receiving care for a fracture. Data are based on visits in multiple settings and do not represent unique cases. (Reference Table 5B.2.1 PDF CSV)

Trends in the number of fractures treated between 1998 and 2013 show relatively stable numbers. Around 3 million fractures of the upper and lower limbs are treated in emergency rooms each year, another 9 million in physician’s offices, with about 900,000 upper and lower limb fracture patients hospitalized each year. (Reference Table 5B.5.1 PDF CSV)

Fractures of the radius and ulna (lower arm) are the most frequently treated fracture, with 2.7 million treated in 2013. These fractures are usually treated in the emergency department (ED) or a physician’s office, with a  third (33%) occurring in the under 18 years of age population. Fractures of the ankle, humerus (upper arm), hand, and foot each account for 1.2 million to 1.6 million of fractures treated. These fractures occur at all ages, but more often in the middle ages of 18 to 64 years. Fracture of the neck of the femur, a serious injury with 77% occurring to persons over age 65 and more often among women, accounting for 68% of first line visits in the hospital or emergency department. Nearly 1.2 million neck of femur fractures visits were treated in 2013, with more than one-half (56%) seen initially in the ED or the hospital. (Reference Table 5B.5.2 PDF CSV)

In 2013, fractures of the lower limb first treated in the ED had a higher rate of transfer to the hospital (35%) than did upper limb fractures (10%). This is likely due to neck of femur fractures in the older population, as 66% of lower limb fractures for persons age 65 and older treated in the ED were transferred to the hospital. However, fractures to the trunk were the most serious, and 42% treated in the ED were transferred to the hospital. When hospitalized fracture patients were discharged, more than 1 in 2 (58%)  with a lower limb fracture were discharged to skilled nursing, intermediate care, or another facility, while another 11% had home healthcare. Among discharged patients age 65 and over, 80% with a lower limb fracture went to additional care while 8% had home healthcare. (Reference Table 5B.5.3 PDF CSV; Table 5B.5.4 PDF CSV)


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