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Arm Fracture Can Predict Hip Fracture Risk
Journal of Bone and Joint Surgery
March 13, 2009
Older women who suffer a fracture of the upper arm are five times more likely than average to sustain a hip fracture within a year, a new study finds.
The results, say researchers, suggest that when an elderly woman suffers a broken arm, steps should quickly be taken to reduce her risk of future falls and bone fractures -- such as assistive devices to prevent falls at home and medications to treat bone loss.
"There have been studies in the past showing a relationship between upper arm fractures and hip fractures," lead researcher Dr. Jeremiah Clinton said in a news release, "but we wanted to determine when that risk is greatest."
"By recognizing when that period of increased risk occurs, physicians have a window of opportunity to take steps that may possibly prevent a subsequent fracture," said Clinton, an orthopedic surgeon at the University of Washington in Seattle.
The study, reported in the Journal of Bone and Joint Surgery, involved
8,049 older, white women with no history of upper arm or hip fracture. Over an average follow-up of 9.8 years, 321 suffered a fracture to the upper arm, 44 of whom later broke a hip.
Overall, Clinton's team found, women with an arm fracture had a more than five-fold higher than normal risk of sustaining a hip fracture in the year after the arm injury.
There was no increased risk beyond the 1-year mark, however.
The reason for the short-term risk of hip fracture is not completely clear, according to the researchers. One possibility is that both arm and hip fractures often result from a similar reaction to falls, Clinton explained.
Whereas younger people typically try to catch themselves when they are falling, he said, studies show that elderly adults often "tuck and roll," which puts more stress on the shoulder and hip.
Clinton said that it's important for women who suffer an arm fracture to try to figure out the cause. Common reasons for falls in the elderly include medication side effects, like dizziness; neurological problems; poor vision; and mobility and balance problems.
"One of the first steps a patient should take following a fall is to talk with their orthopedist and other physicians to determine the cause," Clinton advised.
"Once the cause is more clearly understood," he said, "the proper steps can be taken to decrease a patient's risk of having another fall and potentially future fractures."
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