Aktaş Seref, Celik Yahya
Department of Orthopedics and Traumatology, Acibadem Hospital, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2004 Oct;10(4):250-2.
Falls are the major cause of hip fractures in elderly patients. The aim of this prospective study was to investigate the underlying causes of fall-induced hip fractures in the elderly.
The study included 32 patients (18 males, 14 females; mean age 78 years; range 57 to 95 years) who had proximal femoral fractures following an unexpected and sudden fall from about a meter height at a moment of lying, sitting, or standing position. Underlying causes of falls were sought, including previous falls, stroke, polyneuropathy, motion disorders, dementia, vision problems, fainting, vestibular pathologies, and cardiac diseases.
Eight patients (25%) had a history of previous falls and 12 patients (37.5%) had a history of stroke. Polyneuropathy, Parkinson's Disease, and dementia were diagnosed in eight (25%), three (9.4%), and five (15.6%) patients, respectively. Twenty-one patients (65.6%) had neurologic diseases, 11 patients (34.4%) had cataract or other vision problems, eight patients (25%) had osteoarthritis and rheumatoid arthritis, 10 patients (31.3%) had vestibular pathologies, and 17 patients (53.1%) had cardiac diseases such as heart failure, orthostatic hypotension, ischemic heart disease, and arrhythmia.
In order to prevent recurrent falls, risk factors associated with falls should be determined and preventive treatment and measures should be put into practice in elderly patients who have fall-induced injuries.
跌倒为老年患者髋部骨折的主要原因。本前瞻性研究旨在调查老年患者因跌倒导致髋部骨折的潜在原因。
本研究纳入32例患者(男性18例,女性14例;平均年龄78岁;范围57至95岁),这些患者在躺卧、坐立或站立时意外从约一米高处突然跌倒后发生股骨近端骨折。探寻跌倒的潜在原因,包括既往跌倒史、中风、多发性神经病、运动障碍、痴呆、视力问题、昏厥、前庭疾病和心脏病。
8例患者(25%)有既往跌倒史,12例患者(37.5%)有中风史。分别有8例(25%)、3例(9.4%)和5例(15.6%)患者被诊断为多发性神经病、帕金森病和痴呆。21例患者(65.6%)患有神经系统疾病,11例患者(34.4%)患有白内障或其他视力问题,8例患者(25%)患有骨关节炎和类风湿关节炎,10例患者(31.3%)患有前庭疾病,17例患者(53.1%)患有心脏病,如心力衰竭、体位性低血压、缺血性心脏病和心律失常。
为预防反复跌倒,应确定与跌倒相关的危险因素,并对有跌倒所致损伤的老年患者实施预防性治疗和措施。