Short Tilte:Fall-related fractures in persons with spinal cord impairment: A descriptive analysis
Year, Volume, Issue, Page(s):03, 20, 1, 30-37
Study describes the incidence, etiology, location of fracture, treatment, and health care utilization of fall-related fracture in patients with spinal cord impairments (SCI). A retrospective review of 45 patients with SCI who sustained fractures, nonconcomitant with the onset of their initial injury, was completed at a Veterans Health Administration hospital over a 10-year period. Of the 24 veterans who sustained fall-related fractures, 3 (12 percent) were found to have repeated falls with fractures. Falls were sustained during transfer activities (44 percent), transferring or riding in a vehicle (30 percent), moving in bed (22 percent), propelling (15 percent), reaching (11 percent), and showering (7 percent). Factors contributing to falls included loss of balance, equipment failure, muscle spasms, excessive speed, not wearing protective straps, and narcolepsy. The 24 subjects sustained 31 fractures in 27 fall episodes. Lower extremity fractures accounted for 97 percent of the injuries and a fractured 7th rib accounted for one injury. Tibial fractures occurred more frequently than femoral or ankle fractures. Four (15 percent) fall episodes resulted in bilateral fractures. The treatment of choice was to immobilize the fractured extremity with a soft, well-padded splint. Over 80 percent of the patients with fall-related fractures were hospitalized with a mean of 66 inpatient days per patient.