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Increasing Burden of Upper-Extremity Fractures in the Middle East and North Africa (Mena): A 30-Year Analysis of the Epidemiology and Causes of Injuries Publisher Pubmed



Hoveidaei AH1 ; Nakhostinansari A2, 3 ; Namdari S4 ; Hosseiniasl SH3, 5 ; Khonji MS6 ; Selkghaffari M1 ; Pouramini A3 ; Laporte DM7
Authors
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Authors Affiliations
  1. 1. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, United States
  5. 5. Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, United States

Source: Journal of Bone and Joint Surgery Published:2024


Abstract

Background:Upper-extremity fractures (UEFs) account for a large proportion of bone fractures and are costly to both health and the economy. The fracture burden in the Middle East and North Africa (MENA) is influenced by the region's diverse cultural, economic, and political status. This study examined UEF epidemiology and causes across the MENA region and within the 21 MENA countries as categorized by the Global Burden of Disease (GBD) data set.Methods:On the basis of GBD data, this study evaluated the epidemiology of UEFs from 1990 to 2019. The causes of injuries, incidence, number of years of healthy life lost due to disability (YLD), and their association with the Socio-demographic Index (SDI) were obtained and calculated for males and females in all age groups.Results:From 1990 to 2019, the age-standardized incidence rate (ASIR) of UEFs in the MENA region increased by 2.33%, to 1,086.39 per 100,000 people, and the YLD rate increased 15.69%, to 9.17 per 100,000, opposing the global decreasing trends. Fractures of the radius and/or ulna had the highest ASIR (505.32 per 100,000) of all UEF types in 2019. The clavicle, scapula, and humerus had the highest increasing trend among the fracture sites. In 2019, Saudi Arabia had the highest ASIR of UEFs (2,296.93 per 100,000). Afghanistan had the highest age-standardized YLD rate due to UEFs (19.6 per 100,000) in 2019, with Syria (153.32%) and Iran (37.04%) experiencing the greatest increase and decrease, respectively, from 1990 to 2019. Falling was the leading cause of UEFs, accounting for 45.05% of incidence and 41.19% of YLD overall.Conclusions:Contrary to global trends, UEFs increased in the MENA region during the study period. Countries with higher fracture incidence and YLD should consider preventive and rehabilitation strategies. © 2024 Lippincott Williams and Wilkins. All rights reserved.
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