Hip fractures among the elderly: Causes, consequences and control

Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Ageing Research Reviews (Impact Factor: 4.94). 02/2003; 2(1):57-93. DOI: 10.1016/S1568-1637(02)00045-4
Source: PubMed


This review examines all pertinent literature sources published in the English language between 1966 to the present concerning hip fracture epidemiology, hip fracture injury mechanisms, and hip fracture management strategies. These data reveal hip fractures have several causes, but among these, the impact of falls and muscle weakness, along with low physical activity levels seems to be the most likely explanation for the rising incidence of hip fracture injuries. Related determinants of suboptimal nutrition, drugs that increase fall risk and lower the safety threshold and comorbid conditions of the neuromuscular system may also contribute to hip fracture disability. A number of interventions may help to prevent hip fracture injuries, including, interventions that optimize bone mass and quality, interventions that help prevent falls and falls dampening interventions. Rehabilitation outcomes may be improved by comprehensive interventions, prolonged follow-up strategies and ensuring that all aging adults enjoy optimal health.

  • Source
    • "Hip fractures are a prevalent injury in the elderly population[1]and major cause of morbidity and mortality[2]. The number of hip fractures is projected to increase dramatically due to the aging population. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Intracapsular hip fractures (ICHF) are a common cause of morbidity and mortality and pose a great economic burden on the health care systems. Appropriate surgical treatment requires balancing optimal outcomes with the cost of treatment to the health care system. While in elderly patients with displaced ICHF arthroplasty became the standard of care, the internal fixation method for conserving the femoral head in younger patients or in nondisplaced ICHF is still in debate. We compared a dynamic locking plate with the standard cancellous cannulated screws (CCS) for treatment of nondisplaced ICHF.
    Full-text · Article · Oct 2015 · Injury
  • Source
    • "Proximal femoral fractures are traditionally considered to be a disease of the elderly caused by simple falls in over 90% of cases [11]. In the younger population, they are often a result of highenergy trauma such as motor vehicle accidents and fall from heights, often accompanied with associated injuries [12] [13]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cycling is gaining more popularity both as a sport, on and off-road and also as a means of commute. Cycling accidents harbour significant injury risks including fractures. Proximal femoral fractures are uncommonly associated with cycling in the young adult population. The purpose of this study is to describe this unique pattern of injury as well as the outcome of proximal femoral fractures caused by cycling in the young to mid age population.
    Preview · Article · May 2014 · Injury
  • Source
    • "Incidence of falls escalates with age, events exacerbated by declines in muscle mass, strength, coordination and balance [1], [2]. When considered in concert with age-related decline in bone quality and quantity [3], this elevated risk of falling portends an increase in the incidence of injury, including fracture [4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; p<0.05), while three measures of balance were significantly worse in fallers as compared to older persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score ("B-score") algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly "non-fallers" had a B-score of 0.334, compared to 0.645 for those with a fall history (p<0.001). A weighted amalgam of postural sway elements may identify individuals at greatest risk of falling, allowing interventions to target those with greatest need of attention.
    Full-text · Article · Aug 2013 · PLoS ONE
Show more