title: The human cost of fracture.
abstract: In this population-based, observational study, we document the personal burden of fracture and utilization of community and health services for women during the 12-month period following a fracture. Participants were 598 women (aged 35-92 years) with incident fracture in the years 1994-1996 who were enrolled in the Geelong Osteoporosis Study. Almost all hip fracture cases and 27% of nonhip fracture cases were hospitalized. Homes were modified in 14% of cases, and 32% of the women purchased or hired equipment to assist with activities of daily living. Three-quarters of women with hip, pelvis, or lower limb fractures were confined to the home, had to walk with a walking aid, or could walk only short distances for several weeks. After a year, nearly one-half had not regained prefracture mobility. One-seventh of women with upper-limb fractures did not venture outside the home for at least 6 weeks. Nearly half of all fracture cases needed help with personal care and housework during the first 6 weeks. After 6 months, 3.4% of all patients and 19.6% of hip, 12.8% of humeral, and 4.7% of spine fracture patients required assistance with bathing and showering. After a year, more than half of the hip fracture cases remained restricted regarding housework, gardening, and transport. These findings have important implications for rehabilitation therapy. A fracture, regardless of site, had a major impact on a woman's lifestyle and well-being. Most women were restricted in their activities of daily living and suffered loss of confidence and independence. Short-term morbidity was common for all fractures, with varying degrees of prolonged morbidity often extending to at least a year postfracture.
authors.affiliation: University of Melbourne, Department of Clinical and Biomedical Sciences: Barwon Health, P.O. Box 281, 3220, Geelong, Victoria, Australia. juliep@barwonhealth.org.au
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.forename: Kerrie M
authors.initials: KM
authors.lastname: Sanders
authors.forename: Frouckje M
authors.initials: FM
authors.lastname: Hoekstra
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Henry
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nicholson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kotowicz
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services; D017281:Cost of Illness; D004779:Environment Design; D005190:Family; D005260:Female; D050723:Fractures, Bone / Q000188:drug therapy / Q000191:economics* / Q000523:psychology; D006620:Hip Fractures / Q000191:economics / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009983:Orthopedic Equipment; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance / Q000379:methods; D011998:Recreation; D016138:Walking / Q000502:physiology