Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury

Introduction. Ground-level falls are typically regarded as a minor mechanism of injury that do not necessitate trauma team activation; however, they represent a significant proportion of hospitalised trauma and can result in multisystem injury. Case Presentation. A 79-year-old nursing home resident...

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Main Authors: Simon Parker, Arash Afsharpad
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2014/164632
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author Simon Parker
Arash Afsharpad
author_facet Simon Parker
Arash Afsharpad
author_sort Simon Parker
collection DOAJ
description Introduction. Ground-level falls are typically regarded as a minor mechanism of injury that do not necessitate trauma team activation; however, they represent a significant proportion of hospitalised trauma and can result in multisystem injury. Case Presentation. A 79-year-old nursing home resident was brought to the emergency department following an unwitnessed fall. She suffered dementia and had a seizure in the department resulting in a reduced GCS, making history and examination difficult. She was diagnosed with a right proximal humerus fracture and admitted under joint orthopedic and medical care. Following orthopedic review, further X-rays were requested which showed bilateral neck of femur fractures. The following day she had bilateral hip hemiarthroplasties and K-wire stabilisation of the right shoulder. Several days later, when cognition had improved, she was noted to be avoiding use of the left arm and was found to also have a left proximal humerus fracture which was managed conservatively. Conclusion. Trauma patients with reduced cognitive function should undergo full ATLS assessment, and a prospective trial is required to see if age should be incorporated as a criteria for trauma team activation. More liberal use of advanced imaging such as a full body CT-scan may be beneficial.
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spelling doaj-art-2bd6a2b2d9bf49e2875d15ae48ad2d1a2025-02-03T01:32:10ZengWileyCase Reports in Orthopedics2090-67492090-67572014-01-01201410.1155/2014/164632164632Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of InjurySimon Parker0Arash Afsharpad1North Central Thames Foundation School, UCL Medical School, Royal Free Hospital, Room GF/664, Rowland Hill Street, London NW3 2PF, UKTrauma & Orthopaedics, Barnet Hospital, Wellhouse Lane, Barnet, Hertfordshire EN5 3DJ, UKIntroduction. Ground-level falls are typically regarded as a minor mechanism of injury that do not necessitate trauma team activation; however, they represent a significant proportion of hospitalised trauma and can result in multisystem injury. Case Presentation. A 79-year-old nursing home resident was brought to the emergency department following an unwitnessed fall. She suffered dementia and had a seizure in the department resulting in a reduced GCS, making history and examination difficult. She was diagnosed with a right proximal humerus fracture and admitted under joint orthopedic and medical care. Following orthopedic review, further X-rays were requested which showed bilateral neck of femur fractures. The following day she had bilateral hip hemiarthroplasties and K-wire stabilisation of the right shoulder. Several days later, when cognition had improved, she was noted to be avoiding use of the left arm and was found to also have a left proximal humerus fracture which was managed conservatively. Conclusion. Trauma patients with reduced cognitive function should undergo full ATLS assessment, and a prospective trial is required to see if age should be incorporated as a criteria for trauma team activation. More liberal use of advanced imaging such as a full body CT-scan may be beneficial.http://dx.doi.org/10.1155/2014/164632
spellingShingle Simon Parker
Arash Afsharpad
Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
Case Reports in Orthopedics
title Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
title_full Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
title_fullStr Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
title_full_unstemmed Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
title_short Ground-Level Geriatric Falls: A Not-So-Minor Mechanism of Injury
title_sort ground level geriatric falls a not so minor mechanism of injury
url http://dx.doi.org/10.1155/2014/164632
work_keys_str_mv AT simonparker groundlevelgeriatricfallsanotsominormechanismofinjury
AT arashafsharpad groundlevelgeriatricfallsanotsominormechanismofinjury