Objectives: Traditionally, the approach to fracture prevention has focused on increasing bone mineral density while typically lacking a combined clinical approach to falls prevention and vice versa. To resolve this gap, we implemented and evaluated a novel combined model of care to the assessment and prevention of osteoporosis and falls in the outpatients setting.
Setting: Falls and Fractures Clinic (FFC) at Nepean Hospital (Penrith, NSW, Australia).
Participants: Pre-effects and posteffects assessment of 106 community-dwelling older patients referred from the community.
Primary And Secondary Outcome Measures: Previous falls and fractures were recorded. Clinical, functional and paraclinical evaluations were performed. A comprehensive multidisciplinary care plan was then tailored based on the presence of risk factors. Six-month follow-ups were performed assessing the incidence of falls and fractures, change in risk factors for falls and level of risk, with the recommended plan.
Results: We report that 97% of patients had a fall in the preceding 6 months, 47.6% of whom experienced a fracture from the fall. Furthermore, 64% of patients had a marked risk for falling by Physiological Profile Assessment (PPA), 90% had intermediate-high 10-year probability of fracture according to FRAX and 78% had sarcopenia. At 6-month follow-up, we observed more than an 80% reduction in falls and recurrent falls, and 50% reduction in fractures. In addition, 65% of patients had reduced PPA and a 57% reduction in 10-year fracture probability.
Conclusions: In conclusion, we suggest that a multidisciplinary FFC can provide substantial reductions in falls and fractures for high-risk older people, even over a relatively short 6-month time period. The current model of service provision via traditional falls clinics could be significantly improved by encompassing fracture prevention within the multifactorial approach to interventions.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678026 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2018-027013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Characteristics and Surgical Management of Bilateral Body Mandibular Fractures: A 23-Year Experience.
J Clin Med
December 2024
Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy.
: Mandibular fractures are among the most common facial injuries. Bilateral fractures of the mandibular body region (BBMFs), however, are rare. The aim of this retrospective study was to analyze the characteristics, surgical management, and outcomes of BBMFs in a third-level trauma center in northern Italy.
View Article and Find Full Text PDFIntramedullary Nail Failure in a Subtrochanteric Fracture in a 62-Year-Old Woman.
Cureus
December 2024
Department of Surgery, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Subtrochanteric fractures in older patients are typically due to low-energy falls. The standard of care is intramedullary nailing. The Smith & Nephew Trigen Intertan (Memphis, TN, US) is an intramedullary nail with a novel design that incorporates two integrated compression screws.
View Article and Find Full Text PDFInjury pattern of feet and lower limbs in a feet-first fall from height.
Forensic Sci Med Pathol
January 2025
State Institute of Legal Medicine, Turmstrasse 21, Berlin, 10559, Germany.
In fatalities caused by falls from height, the analysis of the injury pattern, alongside with circumstantial data, is crucial for understanding the dynamics of the incident. In rare cases, even a differentiation between accidental and intentional events might be possible. The injury pattern of the lower limbs is particularly significant in this context.
View Article and Find Full Text PDFPediatric Craniofacial Injuries Involving Alcohol: An Epidemiologic Study.
J Craniofac Surg
January 2025
Department of Plastic and Reconstructive Surgery, Children's Hospital Colorado, Aurora, CO.
Introduction: Alcohol intoxication significantly increases an individual's risk for a variety of injuries including craniofacial injuries, although this research is limited to adults. Further research is needed on pediatric craniofacial injuries related to alcohol use in children, a group inherently different in anatomy and developmental considerations from adults. This study aims to identify alcohol-related craniofacial injury patterns, injury mechanisms, and patient disposition in the pediatric population presenting to the emergency department.
View Article and Find Full Text PDFChallenging management of multifocal upper extremity fractures in a polytrauma setting: A case report.
Int J Surg Case Rep
December 2024
Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Department Orthopedics and Traumatology, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia. Electronic address:
Introduction And Importance: Multifocal fractures in a single upper extremity represent a significant clinical challenge, often resulting from high-energy impacts such as motor vehicle accidents or severe falls. These injuries require complex, multifaceted approaches in management, spanning initial acute care to long-term rehabilitation. This paper examines the complexities of diagnosing, treating, and rehabilitating multifocal upper extremity fractures, highlighting the importance of timely intervention and a multidisciplinary approach to maximize functional recovery, minimize long-term disability and the prognosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!