Global, regional, and national burden of clavicle, scapula, or humerus fracture in 204 countries and territories, 1990 to 2021: A systematic analysis from the Global Burden of Disease Study 2021
Clinical Snapshot
PICO Framework
| P — Population | Global population across 204 countries and territories, stratified by age, sex, region, and socio-demographic index |
| I — Intervention | Not applicable (descriptive epidemiological study) |
| C — Comparator | Temporal trends (1990-2021) and geographical/demographic comparisons |
| O — Outcomes | Age-standardized incidence rate, prevalence rate, and years lived with disability (YLDs) for clavicle, scapula, or humerus fractures |
Bottom Line
This comprehensive global analysis reveals declining age-standardized incidence rates of upper limb fractures from 1990-2021, yet absolute case numbers continue rising due to population growth and aging. High socio-demographic index regions, including Australia, face the greatest burden with incidence rates exceeding 300 per 100,000 person-years. The study identifies women aged 60+ as a priority population for targeted prevention strategies. While methodologically robust using established GBD frameworks, the descriptive nature limits direct clinical application. The findings support current Australian approaches to osteoporosis prevention and highlight the need for sustained fracture prevention programs, particularly in aging populations. Regional variations suggest opportunities for targeted public health interventions, though specific prevention strategies require additional intervention studies.
Key Findings
P Value: Not reported
Effect Size: Global ASIR declined from 276.68 to 220.94 per 100,000 person-years (1990-2021)
Primary Outcome: Age-standardized incidence rate of clavicle, scapula, or humerus fractures
Nnt Or Sensitivity: Annual percentage change: -0.78% (95% UI: -0.82% to -0.73%)
Confidence Interval: 2021 ASIR: 172.60-280.99 per 100,000 person-years
Clinical Application
High feasibility for surveillance and prevention planning in Australian healthcare system Australia likely falls within high-SDI category with elevated burden rates. Relevant for RACGP fracture prevention guidelines and PBS osteoporosis medication coverage decisions All age groups with particular relevance to women aged ≥60 years and high-SDI populations
Abstract
Clavicle, scapula, or humerus fracture represent a major public health challenge, yet their epidemiology and health burden remain poorly characterized. Using the Global Burden of Disease 2021 framework, we quantified incidence, prevalence, and years lived with disability (YLDs) of clavicle, scapula, or humerus fractures across 204 countries from 1990 to 2021. Estimates were stratified by age, sex, region, and socio-demographic index (SDI), and reported with 95% uncertainty intervals (UIs) from Bayesian models. Globally, the age-standardized incidence rate (ASIR) declined from 276.68 (95% UI: 219.06-346.71) per 100,000 person-years in 1990 to 220.94 (95% UI: 172.60-280.99) per 100,000 person-years in 2021, with an estimated annual percentage change of -0.78% (95% UI: -0.82% to -0.73%). High SDI regions showed the greatest ASIR (300.30 per 100,000 person-years), age-standardized prevalence rate (112.03 per 100,000 person-years), and age-standardized YLDs rate (3.72 per 100,000 person-years). In 2021, Eastern Europe had the highest ASIR (465.06 per 100,000 person-years), while Australasia led in age-standardized prevalence rate (151.42 per 100,000 person-years) and age-standardized YLDs rate (5.04 per 100,000 person-years). China ranked first in absolute prevalence (1.21 million, 95% UI: 1.04-1.39 million) and YLDs (40,235, 95% UI: 24,471-61,196). Despite declines in age-standardized rates, absolute cases increased substantially, highlighting demographic and regional disparities. Priority populations for targeted prevention include women aged ≥60 years and residents of high-SDI regions, as these strata accounted for the highest burden across incidence/prevalence/YLD rates.
References
- 1.Sun, X., Yao, T., & Wang, F. (2026). Global, regional, and national burden of clavicle, scapula, or humerus fracture in 204 countries and territories, 1990 to 2021: A systematic analysis from the Global Burden of Disease Study 2021. Medicine, 105(21), e48862. https://doi.org/10.1097/MD.0000000000048862
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