Fracture epidemiology and control in a developmental center.

Area of Science:

• Geriatrics
• Orthopedics
• Developmental Disabilities Research

Background:

• Developmental centers house individuals with intellectual and developmental disabilities.
• Fracture risk and contributing factors in this population are not well-established.
• High fracture rates can lead to significant disability and healthcare costs.

Purpose of the Study:

• To determine the incidence and characteristics of fractures in residents of a developmental center.
• To identify risk factors associated with increased fracture rates in this population.
• To inform the development of targeted prevention strategies.

Main Methods:

• Retrospective cohort study over 3.5 years.
• Analysis of fracture data from 994 residents.
• Comparison of fracture rates with the general US population.
• Identification of demographic, clinical, and environmental risk factors.

Main Results:

• 182 fractures occurred in 994 residents, a rate of 5.2 per 100 person-years (1.7x US population).
• Higher fracture rates were associated with epilepsy, older age, male gender, white race, independent ambulation, osteoporosis, and intermediate care units.
• Hand/foot fractures comprised 58% of cases; femur fractures occurred in 7%. Falls caused 23% of fractures, with 58% having indeterminable causes.

Conclusions:

• Fracture incidence is substantially elevated in developmental center residents.
• Specific risk factors, including epilepsy and independent ambulation, are critical targets for intervention.
• Fractures without apparent injury are common and may represent a significant, preventable source of disability.