What are the 3 common causes of falls?
> Mechanical: trips ad falls
Cardiovascular
Neurological
What are some risk factors for falls?
> Weak muscles, poor balance, foot problems (poor nails, bunions + poor footwear)
Dizziness, light headedness, fainting or other LOC
Vision loss
Delirium/dementia affecting problem solving abilities
Some medications, alcohol
Bladder / bowel problems
Occupations at heights
Socioeconomic factors including poverty, overcrowded housing, sole parenthood, young maternal age
Underlying medical conditions, such as neurological, cardiac or other disabling conditions
Unsafe environments
How can falls be prevented?
> Screening within living environments for risks for falls
Clinical interventions to modify risk factors-Muscle strengthening and balance retraining, dynamic balance and
strength training
Use of hip protectors for those at risk of a hip fracture due to a fall
How many people die from falls annually?
> Second leading cause of accidental or unintentional injury deaths worldwide
An estimated 646 000 individuals die annually from falls globally
Adults older than 65 years of age suffer the greatest number of fatal falls
Can be fatal or non-fatal
What influences pain?
> Biological factors
Psychological factors
Social factors
What are the 2 types of pain?
> Acute pain = useful for stopping use of injury to let it heal
Chronic pain = ongoing for >6 months
How should you asses a fracture?
> Check skin – look
Feel
Move: The joint above and below the fracture
Neurovascular status - tells us if it is urgent
How should fractures be managed?
> Reduction
Immobilisation
Rehabilitation
What is fracture callus?
Connective tissue mix of blood and cartilaginous tissue, which then leads to endochondral ossification.
What is osteoporosis?
A progressive systemic skeletal disease
- Characterized by low bone mass and microarchitectural deterioration of bone tissue
- With a consequent increase in bone fragility and susceptibility to fracture
What are soe risk factors for osteoporosis?
> Advancing age-post-menopausal state (for women)
Having a family history of osteoporosis-smoking, excessive alcohol consumption
Exposure to corticosteroids
Low dietary calcium intake
Hyperthyroidism, coeliac disease, hyperparathyroidism, hypogonadism, Cushing’s syndrome.
How is osteoporosis diagnosed?
Using DEXA scans to measure bone mineral density and FRAX (to calculate risk)
How can osteoporosis be treated?
> Lifestyle (weight bearing exercises)
Medication, including HRT, bisphosphonates and denosumab
What is a fragility fracture?
A fracture bone caused by low energy trauma
What bones are most likely to be involved in a fragility fracture?
> Hip
Vertebral column
Distal radius
Proximal humerus
Pelvis
