Am J Emerg Med - WalkBoston



Am J Emerg Med. 1998 Jan;16(1):52-5.

Fractures and other injuries from falls after an ice storm.

Smith RW, Nelson DR.

Emergency Medicine and Trauma Center, Methodist Hospital of Indiana, Indianapolis, USA.

Abstract

This is a retrospective review of all patients seen at an urban emergency department for 9 days after an ice storm because of a fall on ice. Date of presentation, age, sex, and anatomic location and type of injury were tabulated. Risk factors for fractures were identified. A total of 327 injuries were identified in 259 patients. Back injury was most common (19.3%). Ninety-one patients sustained 93 fractures. Ankle fractures were most common (24.7%), followed by fractures of wrist (19.4%) and hip (14.0%). Ankle fractures were more common than other studies of falls after a snow storm. Fracture was significantly related to age (P = .0001). There was a trend for women to sustain fractures (P = .07). Unlike other mass casualty events, fractures and injuries peaked on the 5th and 6th day after the storm, allowing adequate time for mobilizing resources to care for the injured.

PMID: 9451314 [PubMed - indexed for MEDLINE]

MeSH Terms, Substances

MeSH Terms:

• Accidental Falls/statistics & numerical data*

• Adolescent

• Adult

• Age Factors

• Back Injuries/epidemiology*

• Back Injuries/etiology

• Emergency Service, Hospital

• Female

• Fractures, Bone/epidemiology*

• Fractures, Bone/etiology

• Hospitals, Community

• Hospitals, Urban

• Humans

• Ice/adverse effects*

• Indiana

• Male

• Middle Aged

• Retrospective Studies

• Risk Factors

• Weather

Substances:

• Ice

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J Am Geriatr Soc. 2000 Aug;48(8):883-93.

Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence.

Gregg EW, Pereira MA, Caspersen CJ.

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.

Abstract

OBJECTIVES: Assess the relationship between physical activity and risk for falls and osteoporotic fractures among older adults.

DESIGN: Review and synthesis of published literature.

MEASUREMENTS: We searched the literature using MEDLINE, Current Contents, and the bibliographies of articles identified. We included randomized controlled trials (RCT) of the effects of physical activity on the incidence of falls and case-control and prospective cohort studies of the association of physical activity with osteoporotic fracture risk. We also summarized mechanisms whereby physical activity may influence risk for falls and fractures.

RESULTS: Observational epidemiologic studies and randomized clinical trials evaluating the effectiveness of physical activity programs to prevent falls have been inconclusive. However, many studies have lacked adequate statistical power, and recent trials suggest that exercise, particularly involving balance and lower extremity strength training, may reduce risk of falling. There is consistent evidence from prospective and case-control studies that physical activity is associated with a 20-40% reduced risk of hip fracture relative to sedentary individuals. The few studies that have examined the association between physical activity and risk of other common osteoporotic fractures, such as vertebral and wrist fractures, have not found physical activity to be protective.

CONCLUSIONS: Epidemiologic studies suggest that higher levels of leisure time physical activity prevent hip fractures and RCTs suggest certain exercise programs may reduce risk of falls. Future research needs to evaluate the types and quantity of physical activity needed for optimal protection from falls and identify which populations will benefit most from exercise.

PMID: 10968291 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms

Publication Types:

• Review

MeSH Terms:

• Accidental Falls/prevention & control*

• Accidental Falls/statistics & numerical data*

• Activities of Daily Living

• Aged*

• Aged, 80 and over

• Case-Control Studies

• Confounding Factors (Epidemiology)

• Exercise*

• Female

• Fractures, Bone/epidemiology*

• Fractures, Bone/etiology*

• Humans

• Incidence

• Leisure Activities

• Male

• Middle Aged

• Osteoporosis/complications

• Prospective Studies

• Randomized Controlled Trials as Topic

• Risk Factors

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Full Text Sources:

• MD Consult

• Ovid Technologies, Inc.

Medical:

• Fractures - MedlinePlus Health Information

• Falls - MedlinePlus Health Information

• Exercise for Seniors - MedlinePlus Health Information

• Exercise and Physical Fitness - MedlinePlus Health Information

Supplemental Content

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