Cadute e fratture nell'anziano. Cause e conseguenze

OBJECTIVE: To evaluate the causes of non-pathologic traumatic fractures in the elderly and their consequences on quality of life. DESIGN: A prospective trial. Follow-up: 12 months for the inpatients and 3 months for the outpatients. SETTING: Basal assessment in orthopaedic hospital; follow-up in geriatric unit. PATIENTS: Both inpatients and outpatients, 65 years and over, both sexes, both living in a nursing home and in their own home, admitted to an orthopaedic hospital because of a fall, with diagnosis of a subsequent fracture. Criteria of exclusion: patients with pathologic fracture. 121 patients were enrolled, 108 had a complete follow-up. SURVEYS: Health and functional status prior to the fracture, causes and concomitant causes of the fall, site of the fracture, complications and functional disabilities. RESULTS: The most frequent cause of fracture is an accidental fall, especially in younger elderly, other causes being acute cardiovascular and neurological diseases. Fractures occur more frequently in females. The most serious injuries affect frailer subjects, with advanced age, neurologic and multiple chronic diseases. Fracture of femur is the most frequent fracture and it has the highest risk complications, functional disabilities and death. CONCLUSIONS: Because of the high frequency of accidental falls, the authors emphasize the necessity of primary prevention, especially the removal of architectural barriers both at home and in public environment.