Skip to main content

Advertisement

Log in

The human cost of fracture

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

In this population-based, observational study, we document the personal burden of fracture and utilization of community and health services for women during the 12-month period following a fracture. Participants were 598 women (aged 35–92 years) with incident fracture in the years 1994–1996 who were enrolled in the Geelong Osteoporosis Study. Almost all hip fracture cases and 27% of nonhip fracture cases were hospitalized. Homes were modified in 14% of cases, and 32% of the women purchased or hired equipment to assist with activities of daily living. Three-quarters of women with hip, pelvis, or lower limb fractures were confined to the home, had to walk with a walking aid, or could walk only short distances for several weeks. After a year, nearly one-half had not regained prefracture mobility. One-seventh of women with upper-limb fractures did not venture outside the home for at least 6 weeks. Nearly half of all fracture cases needed help with personal care and housework during the first 6 weeks. After 6 months, 3.4% of all patients and 19.6% of hip, 12.8% of humeral, and 4.7% of spine fracture patients required assistance with bathing and showering. After a year, more than half of the hip fracture cases remained restricted regarding housework, gardening, and transport. These findings have important implications for rehabilitation therapy. A fracture, regardless of site, had a major impact on a woman’s lifestyle and well-being. Most women were restricted in their activities of daily living and suffered loss of confidence and independence. Short-term morbidity was common for all fractures, with varying degrees of prolonged morbidity often extending to at least a year postfracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Randell A, Sambrook PN, Nguyen TV, Lapsley H, Jones G, Kelly PJ, Eisman JA (1995) Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 5:427–432

    Google Scholar 

  2. Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247

    Google Scholar 

  3. Sanders KM, Nicholson GC, Ugoni AM, Pasco JA, Seeman E, Kotowicz MA (1999) Health burden of hip and other fractures in Australia beyond 2000. Projections based on the Geelong Osteoporosis Study. Med J Aust 170:467–470

    Google Scholar 

  4. Ray NF, Chan JK, Thamer M, Melton LJ 3rd (1997) Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 12:24–35

    Google Scholar 

  5. Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8:611–617

    Google Scholar 

  6. Gabriel SE, Tosteson AN, Leibson CL, Crowson CS, Pond GR, Hammond CS, Melton LJ 3rd (2002) Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 13:323–330

    Google Scholar 

  7. Sambrook PN, Seeman E, Phillips SR, Ebeling PR (2002) Preventing osteoporosis: outcomes of the Australian Fracture Summit. Med J Aust 176:S1–S16

    Google Scholar 

  8. Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–370

    Google Scholar 

  9. Gold DT (1996) The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 18:185S-189S

    Google Scholar 

  10. Randell AG, Nguyen TV, Bhalerao N, Silverman SL, Sambrook PN, Eisman JA (2000) Deterioration in quality of life following hip fracture: a prospective study. Osteoporos Int 11:460–466

    Google Scholar 

  11. Hall SE, Williams JA, Senior JA, Goldswain PR, Criddle RA (2000) Hip fracture outcomes: quality of life and functional status in older adults living in the community. Aust N Z J Med 30:327–332

    Google Scholar 

  12. Finnern HW, Sykes DP (2003) The hospital cost of vertebral fractures in the EU: estimates using national datasets. Osteoporos Int 14:429–436

    Google Scholar 

  13. O’Neill TW, Cockerill W, Matthis C, Raspe HH, Lunt M, Cooper C, Banzer D, Cannata JB, Naves M, Felsch B, Felsenberg D, Janott J, Johnell O, Kanis JA, Kragl G, Lopes Vaz A, Lyritis G, Masaryk P, Poor G, Reid DM, Reisinger W, Scheidt-Nave C, Stepan JJ, Todd CJ, Woolf AD, Reeve J, Silman AJ (2004) Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int 15:760–765

    Google Scholar 

  14. Pasco JA, Henry MJ, Gaudry TM, Nicholson GC, Kotowicz MA (1999) Identification of incident fractures: the Geelong Osteoporosis Study. Aust N Z J Med 29:203–206

    Google Scholar 

  15. Sanders KM, Pasco JA, Ugoni AM, Nicholson GC, Seeman E, Martin TJ, Skoric B, Panahi S, Kotowicz MA (1998) The exclusion of high trauma fractures may underestimate the prevalence of bone fragility fractures in the community: the Geelong Osteoporosis Study. J Bone Miner Res 13:1337–1342

    Google Scholar 

  16. Tinetti ME, Richman D, Powell L (1990) Falls efficacy as a measure of fear of falling. J Gerontol 45:P239–243

    Google Scholar 

  17. Bhala RP, O’Donnell J, Thoppil E (1982) Ptophobia. Phobic fear of falling and its clinical management. Phys Ther 62:187–190

    Google Scholar 

  18. Maki BE, Holliday PJ, Topper AK (1991) Fear of falling and postural performance in the elderly. J Gerontol 46:M123–131

    Google Scholar 

  19. Chrischilles EA, Butler CD, Davis CS, Wallace RB (1991) A model of lifetime osteoporosis impact. Arch Intern Med 151:2026–2032

    Google Scholar 

  20. Elffors L (1998) Are osteoporotic fractures due to osteoporosis? Impacts of a frailty pandemic in an aging world. Aging (Milano) 10:191–204

    Google Scholar 

  21. Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S-17S

    Google Scholar 

  22. Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248–1250

    Google Scholar 

  23. Kanis JA, McCloskey EV (1992) Epidemiology of vertebral osteoporosis. Bone 13:S1–S10

    Google Scholar 

  24. Cooper C, O’Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14:S89-S97

    Google Scholar 

  25. Galindo-Ciocon D, Ciocon JO, Galindo D (1995) Functional impairment among elderly women with osteoporotic vertebral fractures. Rehabil Nurs 20:79–83

    Google Scholar 

  26. Meadows LM, Mrkonjic LA (2003) Breaking—bad news: women’s experiences of fractures at midlife. Can J Public Health 94:427–430

    Google Scholar 

Download references

Acknowledgements

We thank B. Skoric and S. Panahi for collecting and collating the data. The study was funded by grants from the Victorian Health Promotion Foundation and the Geelong Region Medical Research Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Julie A. Pasco.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pasco, J.A., Sanders, K.M., Hoekstra, F.M. et al. The human cost of fracture. Osteoporos Int 16, 2046–2052 (2005). https://doi.org/10.1007/s00198-005-1997-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-1997-y

Keywords

Navigation