A Broken Arm May Portend a Fractured Hip

The elderly are at greater risk for fall-related fractures; their bones are generally more brittle than younger people’s. Falls are also more common in the elderly, due to the effects of medications they take, poor balance, decreased reaction time, or some age-related neurological disorders. A study in the Journal of Bone and Joint Surgery gives emphasis to this increased risk of fractures.

More than 8,000 white women without any previous fractures were enrolled in the Study of Osteoporotic Fractures and followed for an average of 9.8 years. The risk of a hip fracture after a fracture of the humerus (i.e. the upper arm) was calculated after appropriate adjustments were made to compensate for interfering factors.

There were 321 women with a fracture of the upper humerus, and 44 of them subsequently fractured a hip. After adjusting for age and bone mineral density, it was determined that those women with an upper arm fracture were almost twice as likely (actually, 1.83 times) to sustain a hip fracture as women without an arm fracture. The risk was highest in the first year following the arm fracture – more than 6 times greater. By 5 years it had fallen to less than a 60% increased risk.

Hip fracture in the elderly is a dangerous accident; 25% of patients survive less than a year; another 25% will lose some level of independence and may need to move to an assisted-living facility. So anything that can reduce the risk is worth pursuing. Older [persons having a fractured humerus should be assessed for factors that could increase the likelihood of a hip fracture, and treated accordingly: osteoporosis, poor balance, in appropriate medications, and a home that hasn’t been “fall-proofed”.