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Broken shoulder: No laughing matter
Newswise — Older women who suffer a proximal humerus fracture
(sometimes known as a broken shoulder) have
a high risk for also breaking a hip within a
year after the shoulder injury.
A new study presented today at the 75th Annual Meeting of the
American Academy of Orthpaedic Surgeons (AAOS),
found that after a shoulder fracture a
woman’s risk of fracturing a hip within the
following year was five times greater.
The risk decreased after the first year but still remained
elevated. Understanding the connection
between these injuries is important to
preventing hip fractures.
Hip fractures account for more than 350,000 hospital
admissions in the United States and more
than 60,000 nursing home admissions each
year. Women have greater risk because of
their higher susceptibility to osteoporosis.
Statistics show:
• about 70 percent of hip fracture patients
are women
• more than 4 percent of hip fracture
patients die during their initial
hospitalization
• 24 percent die within a year of the injury
• about half of women who sustain hip
fractures lose the ability to walk
independently
Preventing hip fracture poses s a significant quality-of-life
issue. “Earlier studies have shown that
there is an increased risk of hip fracture
after a proximal humerus fracture, but our
study found that there is a defined window
of time in which the risk is much greater
than previously thought.
"Additionally, other research has shown that interventions
within the first three months can reduce the
risk of subsequent fractures,” said Jeremiah
Clinton, MD, co-author of the study and
acting clinical instructor at the University
of Washington, Department of Orthopaedics.
“If we maximize our hip-fracture prevention efforts up front,
we may have a much better chance of helping
the patient avoid a life-changing and
potentially life-ending injury.”
The study followed a group of older, Caucasian women for
nearly 10 years and found that:
• 14 percent of those who suffered a
proximal humerus fracture later sustained a
hip fracture.
(It should be noted that because older women
are at very high risk for hip fracture, more
than 8 percent of the women who did not
break a shoulder also suffered a fractured
hip.)
The strongest risk factors for hip fracture were age and hip
bone mineral density. Other factors
included:
• self-reported health status
• height at 25 years of age
• history of recent falls
• impaired depth perception
• history of prior fractures
Even when controlling these factors, the researchers still
found the increased risk for hip fracture in
the first year after a proximal humerus
fracture.
The reasons for the connection between humerus fracture and
hip fracture are still unclear.
“It may be associated medical problems, limited use of the
injured shoulder, or there could be
something about the treatment for the first
fracture—such as narcotic pain medications
—which could have caused the patient to fall
and break a hip,” Dr. Clinton said.
“Now that we are aware of the relationship between these
types of fractures, we can take precautions,
intervene early and hopefully help to
prevent some hip fractures from occurring.”
The authors stress that this message is the
key point to be made from their new
findings.
Disclosure: Dr. Clinton and his co-authors received no
compensation for this study.
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