Upper extremity fractures in the elderly: consequences on utilization of rehabilitation care.
OBJECTIVE
While hip fractures represent the most dramatic consequence of osteoporosis, fractures of the humerus, forearm and wrist account for one-third of the total incidence of fractures due to osteoporosis in the older population. The aim of this retrospective cohort study was to evaluate rehabilitation care utilization and associated factors in elderly individuals with upper limb fracture.


METHODS
Over two years, 667 patients 65 years of age or older were studied, who presented to the emergency department either from their private homes or nursing homes with an upper extremity fracture. The following outcome variables were collected: gender; age; residence; location of fracture; treatment; discharge destination; length of hospitalization; length of stay in a rehabilitation facility; and ultimate place of habitation after the event.


RESULTS
The most frequent sites of fracture were distal radius (37.2%) and proximal humerus (29.1%). Two-thirds of the patients were treated non-operatively. Inpatient rehabilitation care was necessary for 248 patients (37.2%; length of stay, 46 days). Factors associated with increased care included older age (> or = 80 years), coming from private home, sustaining two fractures, fractures of the humerus, and operative treatment. Six percent of the patients required permanent nursing home care.


CONCLUSIONS
Upper extremity fractures in older people often require prolonged hospitalization and therefore account for considerable health care costs. Reasons are more related to advanced age and living conditions than to particular injury or treatment.
Lübbeke
Anne
A
Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Cantonal Universitaire de Genève, Geneva, Switzerland.
Stern
Richard
R
Grab
Bernard
B
Herrmann
François
F
Michel
Jean-Pierre
JP
Hoffmeyer
Pierre
P
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D006810:Humeral Fractures / Q000534:rehabilitation*; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D010024:Osteoporosis / Q000150:complications / Q000473:pathology; D011885:Radius Fractures / Q000534:rehabilitation*; D012189:Retrospective Studies; D034941:Upper Extremity / Q000473:pathology*