The Effect of Fall Biomechanics on Risk for Hip Fracture in Older Adults: A Cohort Study of Video-Captured Falls in Long-Term Care.
BIOMECHANICS
FALLS
HIP FRACTURE
HIP PROTECTORS
VIDEO CAPTURE
Journal
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
ISSN: 1523-4681
Titre abrégé: J Bone Miner Res
Pays: United States
ID NLM: 8610640
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
11
10
2019
revised:
19
03
2020
accepted:
04
05
2020
pubmed:
14
5
2020
medline:
16
6
2021
entrez:
14
5
2020
Statut:
ppublish
Résumé
Over 95% of hip fractures in older adults are caused by falls, yet only 1% to 2% of falls result in hip fracture. Our current understanding of the types of falls that lead to hip fracture is based on reports by the faller or witness. We analyzed videos of real-life falls in long-term care to provide objective evidence on the factors that separate falls that result in hip fracture from falls that do not. Between 2007 and 2018, we video-captured 2377 falls by 646 residents in two long-term care facilities. Hip fracture was documented in 30 falls. We analyzed each video with a structured questionnaire, and used generalized estimating equations (GEEs) to determine relative risk ratios (RRs) for hip fracture associated with various fall characteristics. All hip fractures involved falls from standing height, and pelvis impact with the ground. After excluding falls from lower than standing height, risk for hip fracture was higher for sideways landing configurations (RR = 5.50; 95% CI, 2.36-12.78) than forward or backward, and for falls causing hip impact (3.38; 95% CI, 1.49-7.67). However, hip fracture risk was just as high in falls initially directed sideways as forward (1.14; 95% CI, 0.49-2.67), due to the tendency for rotation during descent. Falling while using a mobility aid was associated with lower fracture risk (0.30; 95% CI, 0.09-1.00). Seventy percent of hip fractures involved impact to the posterolateral aspect of the pelvis. Hip protectors were worn in 73% of falls, and hip fracture risk was lower in falls where hip protectors were worn (0.45; 95% CI, 0.21-0.99). Age and sex were not associated with fracture risk. There was no evidence of spontaneous fractures. In this first study of video-captured falls causing hip fracture, we show that the biomechanics of falls involving hip fracture were different than nonfracture falls for fall height, fall direction, impact locations, and use of hip protectors. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
Identifiants
pubmed: 32402136
doi: 10.1002/jbmr.4048
pmc: PMC7689902
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1914-1922Subventions
Organisme : CIHR
ID : AMG-100487
Pays : Canada
Organisme : CIHR
ID : Community Support Travel Award #164465
Pays : Canada
Organisme : CIHR
ID : Community Support Travel Award #164472
Pays : Canada
Organisme : CIHR
ID : TEI-138295
Pays : Canada
Organisme : CIHR
ID : TIR-103945
Pays : Canada
Organisme : CIHR
ID : WP5
Pays : Canada
Informations de copyright
© 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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