Author/Editor		Komadina, Radko
Title		The hip fracture is an injury and a disease at the same time
Translated title		Zlom kolka je poškodba in bolezen hkrati
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 77, št. Suppl IV
Publication year		2008
Volume		str. IV-3-10
Language		eng
Abstract		Low bone mineral density (BMD) can not accurately differentiate between those who will experience a hip fracture and those who will not after the fall from standing high. It influences the predicted success of future fracture prevention in less than 50 %. Bone strength explains the ratio between applied force that act to deform the bone in the counter and the reduced ability of osteoporotic bone to resist some more than the physiologic load in the denominator. The Nevitt’s bone fragility factor explains a hip fracture at the same time as an accident (counter) and a disease (denominator). The dominant factor in a hip fracture is the fall of the elderly patient. Falls are not only accidents, but are also a consequence of the normal aging process. Falls are preventable by the multifactorial interdisciplinary prevention program (MIPP). Unfortunately as much as 75 % of women and 90 % of men at high risk in nursing homes are not investigated, and 75 % of those affected are not treated. Conclusions Very useful is Charlson’s comorbidity index with 19 typical geriatric diseases, predicting death in hospitalized elderly with fragility fracture (heart, lung, kidneys, vessels, DM, tumor, liver, dementia, coagulopathies). If the patient has not any comorbidity, his one year mortality is estimated to be 12 %. With 1‐2 comorbidities estimated mortality is 26 %, with 3‐4 comorbidities 52 %, with 5 or more comorbidities the mortality is above 85 %. Inn hip fracture Charlson index is on average 3.4. All comorbidities benefit from early operation and early mobilization.
Descriptors		HIP FRACTURES BONE DENSITY ACCIDENTAL FALLS OSTEOPOROSIS BIOMECHANICS FEMORAL FRACTURES RISK FACTORS AGED