The human cost of fracture

• Published in: Osteoporosis international 2005-12, Vol.16 (12), p.2046-2052
• Main Authors: PASCO, Julie A, SANDERS, Kerrie M, HOEKSTRA, Frouckje M, HENRY, Margaret J, NICHOLSON, Geoffrey C, KOTOWICZ, Mark A
• Format: Article
• Language: English
• Subjects: Absenteeism; Activities of Daily Living; Adult; Aged; Aged, 80 and over; Ankle; Biological and medical sciences; Community Health Services; Cost of Illness; Diseases of the osteoarticular system; Environment Design; Family; Female; Fractures; Fractures, Bone - drug therapy; Fractures, Bone - economics; Fractures, Bone - psychology; Health services; Hip Fractures - economics; Hip Fractures - psychology; Hip joint; Hospitalization; Housework; Humans; Injuries of the limb. Injuries of the spine; Medical sciences; Middle Aged; Morbidity; Orthopedic Equipment; Osteoporosis; Osteoporosis. Osteomalacia. Paget disease; Patient Acceptance of Health Care; Population Surveillance - methods; Questionnaires; Recreation; Traumas. Diseases due to physical agents; Walking - physiology
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-005-1997-y

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.