Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
2Activity
0 of .
Results for:
No results containing your search query
P. 1
The Problem of Osteoporotic Hip Fracture in Australia

The Problem of Osteoporotic Hip Fracture in Australia

Ratings: (0)|Views: 1,122|Likes:
Published by earl58

More info:

Published by: earl58 on Aug 24, 2011
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

06/26/2012

pdf

text

original

 
    b  u    l    l  e   t   i  n     7    6
Bulletin 76 • March 2010
Te problem of osteoporotichip fracture in Australia
Key points
•eage-adjustedincidencerateofosteoporotichipfractureinAustraliadecreasedoverthe10yearsto2006–07,by14%amongmalesandby20%amongfemales.However,theactualnumberofcasescontinuedtoincreaseinbothsexesduetopopulationgrowthandageing.•erewereanestimated16,518osteoporotichipfracturesamongAustraliansaged40yearsoroverin2006–07(175per100,000persons).Almostthree-quartersoftheseoccurredinfemales,whoonaveragewereaged83years(comparedwith81yearsformales).•Around1in9peoplehospitalisedwiththeprincipaldiagnosisofosteoporotichipfracturein2006–07weredischargedtoaresidentialagedcareservice,wherethishadnotpreviouslybeentheirplaceofresidence.•AboriginalandTorresStraitIslanderAustraliansweremuchmorelikelythanotherAustralianstobehospitalisedforanosteoporotichipfracture.eywerealsoonaveragemuchyoungeratthetimeoftheirfracture.•Osteoporosisandosteoporoticfracturescanbepreventedthroughlifestylechangesandbytakingactiontoreducetheriskoffalls.•Malesinparticularmaybenetfromincreasedattentiontohipfractureprevention.
Contents
Key points ...................................................................................................................................................................................................1Introduction ...............................................................................................................................................................................................2Osteoporotic hip ractures in 2006–07 ......................................................................................................................................................5Trends .......................................................................................................................................................................................................14Preventing osteoporotic hip ractures......................................................................................................................................................20Conclusions ...............................................................................................................................................................................................21Appendix 1: Methods and data sources ....................................................................................................................................................22Appendix 2: Data tables ...........................................................................................................................................................................26Abbreviations ...........................................................................................................................................................................................27Reerences ................................................................................................................................................................................................28Acknowledgments ...................................................................................................................................................................................29
 
 Te 
 p ro b le m o f  
os teo po ro t ic  h i
 p  f  rac t u re  i n A u
s t ra lia
2
 
Introduction
Everyday,morethan40Australiansbreaktheirhip.Mostareaged65yearsorover,andmorethanhalfareaged85orover.Virtuallyallofthesepeoplewillbeadmittedtohospital,andmostwillhavesomekindofsurgery.Twopeoplewilldieinthehospital,andatleastfourwillneedtogointoaresidentialagedcarefacility,eitherwhiletheyrecoverorpermanently.Ayearlater,lessthanhalfofthoseoriginal40peoplewillbeabletowalkaswellastheydidbeforethefracture,andanothersixorsevenwillhavedied.OsteoporotichipfracturesareaconsiderableburdenonAustraliansandtheAustralianhealthsystem.Becausetheyaremorecommoninolderpeople,theageingoftheAustralianpopulationmeansthatovertimemorepeoplewillbeatriskofhavingahipfracture.Despitethis,however,theincidencerateofosteoporotichipfractureisfalling.isbulletinpresentsthelatestdataontheincidenceofosteoporotichipfractureinAustralia,aswellaskeyconsequencesofthefracturesuchassurgery,placementinaresidentialagedcarefacilityanddeath.Informationaboutrecenttrendsinosteoporotichipfractureincidenceandvariationacrossthepopulationisalsopresented.
What is an osteoporotic hip fracture?
Ahipfractureisabreakoccurringatthetopofthethighbone(femur),nearthehip(Figure1).Inapersonwithhealthybones,astrongforceisusuallyneededtocauseafracture.Butsomediseasesandconditionscanmakebonesfragile,sothatafracturecanoccurwithasmallamountofforce—forexample,afallfromastandingheightorless.istypeoffractureiscalleda‘minimaltraumafracture’.
Figure 1: Bones o the hip and sites o hip racture
Osteoporosisisaconditionwherethebonesweakenandlosetheirstructuralintegrity.Itismostcommoninolderfemalesbutalsoaectsmales.Peoplewhohaveosteoporosisareathighriskofminimaltraumafractures,whicharethereforesometimescalled‘osteoporoticfractures’.eterm‘osteoporotichipfracture’isusedinthisreporttomeanahipfracturethathasoccurredwitharelativelysmallamountofforce.
 
Bulletin 76 • March 2010
3
Althoughosteoporoticfracturescanoccuranywhereinthebody,theyoccurmorefrequentlyatcertainsites,suchasthehip,pelvis,spine,wristandforearm.Hipfracturesaregenerallymoreseriousanddebilitatingthanfracturesatothersites.eyaredividedintothreesubtypesdependingonwherethethighbonebreaks:femoralneckfracture,pertrochantericfractureandsubtrochantericfracture(Figure1).
Causes and risk factors
Mostosteoporotichipfracturesresultfromafall(Cummings&Melton2002;Kannusetal.2005;Reginsteretal.2005).Othersarecausedwhenthehipstrikes(orisstruckby)asolidobject—forexample,collidingwithatable.Sometimesthefractureoccurswithoutobvioustrauma,whenanordinaryactivitymayputstrainonabone(suchaswhengettingupfromachair).isismorelikelytohappeninpeoplewithsevereosteoporosis.
Risk actors or alls
Riskfactorsforfallsmaybeintrinsic(factorsrelatedtotheindividual)orextrinsic(factorsrelatingtoaperson’senvironment).Intrinsicriskfactorsincludeproblemswithvision,muscleweakness,poorbalance,olderage,cognitiveimpairment,ahistoryoffalling,fearoffalling,useofmedicationscausingdrowsinessorconfusionandconditionsaectingbonestructure(suchasosteoporosis)(Stevens&Olson2000).Extrinsicriskfactorsincludetrippinghazards(suchasunevenground,looserugsorclutter),wetorslipperysurfaces,slipperyfootwear,poorlightingandlackofhandrailsonstairs(AIHW2008a;Kanisetal.2004;OsteoporosisAustralia2006;Stevens&Olson2000).
Risk actors or osteoporosis
emodiableriskfactorsforosteoporosisincludecalciumandvitaminDdeciencies,physicalinactivity,smokingandbeingsubstantiallyunderweight.Non-modiableriskfactorsincludeafamilyhistoryofthecondition,olderageandgeneticpredisposition.Certaindiseasesandconditionsalsoincreasetheriskofosteoporosis,eitherasadirectcomplicationofthediseaseorasaside-eectofthemedicationusedtomanageit(AIHW2008a).eseincluderheumatoidarthritis,chronickidneydisease,eatingdisorders,coeliacdiseaseandasthma.
Other risk actors or hip racture
Factorsthatincreasetheriskofhipfractureindependentlyofanyeectonosteoporosisandfallsincludeahistoryofcorticosteroiduseandpreviousminimaltraumafractures.Peoplewhohavehadaminimaltraumafractureareatincreasedriskofsubsequentfractures,aneectknownasthe‘fracturecascade’.DatafromtheDubboOsteoporosisEpidemiologyStudyshowthattheincreaseinriskpersistsforupto10years,andthat40%ofwomenand60%ofmenwillexperienceasecondfracturewithinthisperiod(Centeretal.2007)

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->