TY  - JOUR
PY  - 2012//
TI  - Multiple fractures in the elderly
JO  - Journal of bone and joint surgery: British volume
A1  - Court-Brown, Charles M.
A1  - McQueen, M. M.
A1  - Duckworth, A. D.
A1  - Aitken, Stuart A.
A1  - Clement, N. D.
SP  - 231
EP  - 236
VL  - 94
IS  - 2
N2  - We present the prevalence of multiple fractures in the elderly in a single catchment population of 780 000 treated over a 12-month period and describe the mechanisms of injury, common patterns of occurrence, management, and the associated mortality rate. A total of 2335 patients, aged ≥ 65 years of age, were prospectively assessed and of these 119 patients (5.1%) presented with multiple fractures. Distal radial (odds ratio (OR) 5.1, p < 0.0001), proximal humeral (OR 2.2, p < 0.0001) and pelvic (OR 4.9, p < 0.0001) fractures were associated with an increased risk of sustaining associated fractures. Only 4.5% of patients sustained multiple fractures after a simple fall, but due to the frequency of falls in the elderly this mechanism resulted in 80.7% of all multiple fractures. Most patients required admission (> 80%), of whom 42% did not need an operation but more than half needed an increased level of care before discharge (54%). The standardised mortality rate at one year was significantly greater after sustaining multiple fractures that included fractures of the pelvis, proximal humerus or proximal femur (p < 0.001). This mortality risk increased further if patients were < 80 years of age, indicating that the existence of multiple fractures after low-energy trauma is a marker of mortality.<p />  <p>Language: en</p>
LA  - en
SN  - 0301-620X
UR  - http://dx.doi.org/10.1302/0301-620X.94B2.27381
ID  - ref1
ER  -