Keywords
Lower limb
Epidemiology
Hospital costs
Hospitalization
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To analyze the epidemiological profile and economic burden of hospitalizations due to lower limb fractures in Brazil through evidence available in the scientific literature. Methods: An integrative review was conducted using the SciELO and Google Scholar databases. A total of 2,248 studies were identified, of which 12 met the inclusion criteria. The selected articles were published between 2014 and 2026 and addressed epidemiological, clinical, and economic aspects of these hospitalizations. Results: Women and older adults predominated among hospitalized patients, whereas males were more prevalent in younger age groups. Femur fractures were the most frequent among older adults and were associated with longer hospital stays and mortality rates ranging from 4.4% to 9%. Among younger individuals, tibia and ankle fractures resulting from high-energy trauma were more common. The average cost per hospitalization ranged from R 672.00 to R 2,581.00, with total expenditures between 34 and 130 million reais and an average hospital stay ranging from 4.8 to 10.4 days. Final considerations: Lower limb fractures represent a significant epidemiological and economic burden in Brazil. These findings reinforce the need for preventive measures and improvements in healthcare delivery.
References
ARAÚJO PP, et al. Trauma ortopédico: causas comuns, diagnósticos e estratégias de prevenção. In: Promoção da Saúde: Perspectivas Integradas, 2025; 12-28.
BATISTA TL, et al. Prevalência de fraturas de platô tibial em pacientes de um hospital público do Piauí. Revista Pesquisa em Fisioterapia, 2020; 10(2): 182-187.
BURGUÊZ D, et al. Evaluation of the surgical treatment of patients over 90 years old with hip fractures and their morbidity and mortality. Revista Brasileira de Ortopedia, 2024; 59(1): 88-92.
COBRA CRMN, et al. Analysisofintensivecareunitadmissions for olderadultswith femoral fractures: a retrospectivecohort. Revista da Escola de Enfermagem da USP, 2024; 58: e20230398.
DANTAS HLL, et al. Como elaborar uma revisão integrativa: sistematização do método científico. Revista Recien, 2022; 12(37): 334-345.
EL FATAH SA, et al. Perfil epidemiológico das fraturas do fêmur proximal em idosos no Hospital Regional de Cotia-SP, Brasil. Acta Ortopédica Brasileira, 2022; 30(4): e251020.
EVANS J, et al. Lesão do Ligamento Cruzado Anterior do Joelho. StatPearls, 2025.
FARIA JUNIOR JR, et al. Determinantsof hospital lengthofstay in olderadultsafter hip fracture: a prospectivecohortstudy. BMC Geriatrics, 2026; 26: 723.
FREIRE GHE, et al. Panorama da morbidade hospitalar por fratura de fêmur no Brasil: um estudo ecológico. BrazilianJournalofImplantologyand Health Sciences, 2024; 6(4): 625-636.
GABELLA JL, et al. Spatiotemporalpatternsof femoral fractures in olderadults: healthcare accessand regional inequalities in southernBrazil. BMC Geriatrics, 2026; 26: 780.
GUZZO WA, et al. Trauma em Curitiba: avaliação multifatorial de vítimas admitidas em um hospital universitário. Revista do Colégio Brasileiro de Cirurgiões, 2020; 47: e20202408.
INTERNATIONAL OSTEOPOROSIS FOUNDATION. Soluções para prevenção de fraturas: perfil do Brasil 2024. 2024.
LI C, LIN Q. Global epidemiology, burden, and causes of lower extremity and pelvic fractures in the past 32 years. Frontiers in Public Health, 2025; 13: 1627867.
MAIA CR, et al. Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis. BMC MusculoskeletalDisorders, 2023; 24(1): 568.
OLIVEIRA SP, et al. Estudo epidemiológico das fraturas do maléolo posterior. Jornal do Pé e Tornozelo, 2025; 1: 1-4.
PINTO AFD, et al. Fatores associados à readmissão em até 30 dias após a alta e à mortalidade hospitalar após cirurgia de fratura proximal do fêmur em idosos: coorte retrospectiva. Revista Brasileira de Ortopedia, 2023; 58(2): 222-230.
PONTIN JCB, et al. Epidemiological profile of patients with tibia diaphysis fracture treated at a tertiary level hospital. Acta Ortopédica Brasileira, 2024; 32(5): e279748.
PORTO AO, et al. Características sociodemográficas e custo de hospitalizações por fratura de fêmur em idosos na Bahia. Journal Health NPEPS, 2019; 4(2): 297-309.
PRADA MB, et al. Traumas ortopédicos: perfil e mecanismos de ocorrência. Revista Saúde e Desenvolvimento Humano, 2022; 10(3): 1-11.
RIBERTO M, et al. Estudo dos determinantes dos custos no atendimento de pacientes com lesão medular decorrente de trauma raquimedular. Acta Fisiátrica, 2023; 30(1): 7-12.
RIBEIRO TA, et al. Predictorsof hip fracturemortalityat a general hospital in South Brazil: anunacceptablesurgicaldelay. Clinics, 2014; 69(4): 253-258.
ROSEMBERG DL, et al. Análise de 45.507 tratamentos cirúrgicos de fraturas da tíbia distal e maleolar ao longo de 14 anos. Acta Ortopédica Brasileira, 2023; 31(2): e263885.
SANTOS L, et al. Custo das internações de pacientes com trauma ortopédico em uma unidade hospitalar. Jornal Brasileiro de Economia da Saúde, 2022; 14(2): 128-132.
SANTOS CMC, et al. The PICO strategy for the research question construction and evidence search. Revista Latino-Americana de Enfermagem, 2007; 15: 508-511.
SILVA ACB, et al. Epidemiological profile of patients with ankle fracture treated in a tertiary level hospital. Acta Ortopédica Brasileira, 2024; 32(6): e282171.
SILVA DMW, et al. Incidenceandexcessmortalityof hip fractures in a predominantlyCaucasianpopulation in the South ofBrazil. ArchivesofOsteoporosis, 2019; 14: 47.
SLIM K, et al. Methodological index for non-randomizedstudies (minors): developmentandvalidationof a new instrument. ANZ JournalofSurgery, 2003; 73(9): 712-716.
SOUZA IAG, PEREIRA CCA, MONTEIRO AL. Assessment ofqualityoflifeusingthe EQ-5D-3L instrument for hospitalizedpatientswith femoral fracture in Brazil. Health andQualityof Life Outcomes, 2018; 16: 181.
STOLNICKI B, TEIXEIRA BCO. O impacto das fraturas do quadril no SUS 2008-2017: o papel do ortopedista. Revista Brasileira de Ortopedia, 2022; 57(4): 521-527.
VASCONCELOS PAB, et al. Femoral fractures in theelderly in Brasil - incidence, lethality, andcosts (2008-2018). Revista da Associação Médica Brasileira, 2020; 66(12): 1702-1706.
WANG Y, et al. Global epidemiology of lower limb fractures: trends, burden, and projections from the GBD 2021 study. Bone, 2025; 193: 117420.
WANG L, et al. Prevalence of osteoporosis and fracture in China: The China Osteoporosis Prevalence Study. JAMA Network Open, 2021; 4(8): e2121106.
ZHANG J, et al. The epidemiology of lower limb fractures: a major United Kingdom trauma centre study. Cureus, 2024; 16(3): e56574.