title: Lower extremity fractures in falls.
abstract: BACKGROUND
  Lower extremity fractures are very common in victims of falls. These fractures are usually associated with other bodily injuries and can lead to permanent disability if appropriate management is not provided. The aim of this study was to evaluate the incidence and outcomes of associated injuries in victims of falls with lower extremity fractures.
  
  
  METHODS
  This is a retrospective review (1995-2006) of all fall-related trauma patients evaluated at our Level I trauma center. Injuries were categorized as: isolated femur fractures (FF), isolated tibia fractures (TF), and both femur and tibia fractures (FTF). Data were analyzed for differences in patterns of injury, associated fractures and injuries, and mortality and morbidity according to age groups within patients with minor body injuries expressed by Abbreviated Injury Score (AIS) < 3.
  
  
  RESULTS
  Three hundred and thirty-two patients (64.8 %) had FF, 164 patients (32 %) had TF, and 16 patients (3.2 %) presented with FTF. The incidence of severe trauma was 9.4 % (Injury Severity Score, ISS > 25). A higher incidence of ISS > 25 was observed in patients with FF. Increased mortality was observed in the elderly group, especially in patients with an isolated femur fracture.
  
  
  CONCLUSIONS
  Patients with a combination of femur and tibia fractures have a significantly higher risk of associated injuries compared to patients with either a femur or a tibia fracture. Elderly patients (≥65 years of age) have higher morbidity and mortality compared to younger patients after falls. Clinicians evaluating these patients should be aware of these injury patterns. Further studies assessing the impact of age and pattern of injury in patients following falls are warranted.
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burn, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
authors.forename: P
authors.initials: P
authors.lastname: Hadjizacharia
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burn, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA. bjoseph@surgery.arizona.edu.
authors.forename: B
authors.initials: B
authors.lastname: Joseph
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burn, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
authors.forename: H
authors.initials: H
authors.lastname: Aziz
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burn, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
authors.forename: V
authors.initials: V
authors.lastname: Pandit
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA, USA.
authors.forename: L S
authors.initials: LS
authors.lastname: Chan
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Demetriades
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burn, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
authors.forename: P
authors.initials: P
authors.lastname: Rhee
keywords: Extremity fractures; Falls; Injury severity
references.citation: Injury. 1999 Aug;30(6):431-7
references.pmid: 10645357
references.citation: J Am Coll Surg. 2002 Jul;195(1):1-10
references.pmid: 12113532
references.citation: J Trauma. 1995 May;38(5):753-6
references.pmid: 7760404
references.citation: J Trauma. 2005 Feb;58(2):342-5
references.pmid: 15706198
references.citation: World J Surg. 1997 Oct;21(8):816-20; discussion 820-1
references.pmid: 9327672
references.citation: Am Surg. 2000 Sep;66(9):863-5
references.pmid: 10993618
references.citation: J Trauma. 2003 Jun;54(6):1146-51; discussion 1151
references.pmid: 12813336
references.citation: J Trauma. 1999 Mar;46(3):453-6
references.pmid: 10088850