Site-Specific Epidemiology of Limb Fractures in Older Adults in Northwest Iran: A Four-Year Retrospective Study

Objectives: This study aimed to describe the site-specific distribution of limb fractures among adults aged 65 years and older who were admitted to a tertiary orthopedic center in Northwest Iran. It also sought to assess sex differences and year-to-year variation in fracture patterns between 2021 and 2024 (1400–1403 Hijri Shamsi). Design: This investigation was conducted as a retrospective, hospital-based study using digitized fracture-registry data. Setting(s): The study was carried out at Shohada Hospital, a tertiary orthopedic referral center in Tabriz, Northwest Iran. Participants: The study population consisted of all inpatients aged≥65 years presented with radiographically confirmed limb fractures between 1400–1403 Hijri Shamsi (2021–2024). Pathological fractures were excluded from analysis. High-energy trauma cases were not systematically excluded due to incomplete mechanism-of-injury data. Outcome Measures: We retrospectively analyzed radiographically confirmed limb fractures using variables that included anatomical fracture site, sex, and year of admission. Pathological fractures were excluded, and high-energy trauma was not systematically removed due to incomplete documentation. Descriptive statistics were computed, and chi-square tests were performed to compare sex distributions across fracture sites and to assess associations between calendar year and hip-fracture counts relative to annual totals. All analyses were conducted using IBM SPSS Statistics version 26 and Microsoft Excel 2019. Results: Hip fractures, including intertrochanteric and femoral-neck types, and distal radius fractures accounted for the largest shares of fracture-related admissions. Sex distributions differed significantly across sites (χ²=340.9, df=28, P<0.001). Hip-fracture proportions varied across study years, although these fluctuations were not statistically significant (intertrochanteric χ²=4.0, df=3, P=0.261; femoral-neck χ²=0.6, df=3, P=0.888). Sex fields were missing for several rare sites. Conclusions: Hip fractures (intertrochanteric and femoral-neck types) and distal radius fractures represented the largest proportions of admissions among older adults in this tertiary referral center. Pronounced sex differences were observed across fracture sites. Because these findings are derived from a single tertiary hospital without population denominators, incidence comparisons should be interpreted cautiously. These results may inform local fall-prevention strategies and osteoporosis-screening initiatives.