Fracture epidemiology and control in a developmental center
G S Lohiya1, F M Crinella, L Tan-Figueroa
1Fairview Developmental Center, Costa Mesa, CA 92626, USA.
The Western Journal of Medicine
|May 27, 1999
Summary
Residents in developmental centers experience significantly higher fracture rates than the general population. Key risk factors include epilepsy, older age, and independent ambulation, highlighting potential for preventable disability.
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.
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