Risk factors and characteristics of falls resulting in hip fracture in the elderly.
BACKGROUND
Risk factors for injurious falls among elderly people differ from those for falls in general. The characteristics of falls play an important role in determining the risk of hip fracture.


OBJECTIVE
To investigate the risk factors associated with the fall characteristics known to be associated with the majority of hip fractures, e.g., a lateral fall and a subsequent impact on the greater trochanter.


METHODS
In this 6 month prospective observational case-control study, 101 individuals aged 65 years and over hospitalized following a hip fracture were interviewed 7-14 days after the accident. Data were also obtained from medical records, focusing on known predisposing and situational risk factors for the fall. We compared the risk factors between two groups: patients who suffered a lateral fall and subsequent impact on the greater trochanter of the femur, and patients who suffered other types of falls.


RESULTS
Only 51.5% of the hip fracture patients reported that they had fallen directly to the side. Apart from age, there were no significant differences between the groups in other factors studied. When considering both fall direction and the area that took the main impact, we found that the majority of patients (85%) reported having fallen onto the posterolateral aspect and/or a fall with an impact on the greater trochanter.


CONCLUSIONS
Our findings did not show differences (except for age) in the factors studied between the groups. This study suggests that both fall direction and the area that takes the main impact should be considered in the characteristics of falls that might cause a hip fracture. Characteristics associated with greatest fracture risk include a fall onto the posterolateral aspect and/or a fall with an impact on the greater trochanter. More studies are needed to evaluate potential risk factors associated with this type of injury.
Aizen
Efraim
E
Dept. of Geriatrics, Fliman Geriatric Hospital, P.O. Box 2263, Haifa 31021, Israel. eaizen_il@yahoo.com
Dranker
Neta
N
Swartzman
Rachel
R
Michalak
Ran
R
D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology* / Q000534:rehabilitation; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D015599:Trauma Severity Indices