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Lower limb fracture presentations at a regional hospital

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Abstract

Summary

We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality.

Purpose

Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures. The study aimed to investigate the epidemiology and burden of these fractures.

Methods

Incident fractures of the hip, femur, tibia/fibula, ankle and foot in women (≥ 20 years) managed through the University Hospital Geelong, Australia, were ascertained from 1 Jan. 2014 to 31 Dec. 2014 from radiology reports. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records.

Results

We identified 585 fractures of the lower limb (209 hip, 42 femur, 41 tibia/fibula, 162 ankle, 131 foot). Most fractures were sustained by women aged ≥ 50 years. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites. Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home.

Conclusions

Fractures of the lower limb occurred frequently in older women. Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life.

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Acknowledgements

The study was supported by the National Health and Medical Council (NHMRC), of Australia, the University of Melbourne Research Grant Scheme, American Society for Bone and Mineral Research (ASBMR), Perpetual Trustees, Amgen and the Geelong Region Medical Research Foundation, but they played no part in the design or conduct of the study; collection, management, analysis and interpretation of the data; or in preparation, review, or approval of the manuscript. MAK was a recipient of the grants from the NHMRC (project nos. 251638, 299831 and 628582), Geelong Regional Medical Research Foundation and Amgen (Europe) GmBH; JAP was a recipient of grants from the NHMRC (project nos. 251638, 299831 and 628582), Geelong Regional Medical Research Foundation, Arthritis Foundation of Australia and Amgen (Europe) GmBH. KLH is supported by an Alfred Deakin Postdoctoral Research Fellowship. SLB-O and LJW are each supported by a Career Development Fellowship from NHMRC (1107510 and 1064272, respectively). DY received an Honours Publication Award from Deakin University School of Medicine.

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Correspondence to K. L. Holloway.

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This study received approval from the Barwon Health Human Research Ethics Committee.

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Holloway, K.L., Yousif, D., Bucki-Smith, G. et al. Lower limb fracture presentations at a regional hospital. Arch Osteoporos 12, 75 (2017). https://doi.org/10.1007/s11657-017-0369-5

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