{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:52:07Z","timestamp":1770753127372,"version":"3.50.0"},"reference-count":21,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"2","license":[{"start":{"date-parts":[[2012,2,1]],"date-time":"2012-02-01T00:00:00Z","timestamp":1328054400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p> We present the prevalence of multiple fractures in the elderly in a single catchment population of 780 000 treated over a 12-month period and describe the mechanisms of injury, common patterns of occurrence, management, and the associated mortality rate. A total of 2335 patients, aged \u2265 65 years of age, were prospectively assessed and of these 119\u00a0patients (5.1%) presented with multiple fractures. Distal radial (odds ratio (OR) 5.1, p\u00a0&lt; \u00a00.0001), proximal humeral (OR 2.2, p &lt; 0.0001) and pelvic (OR 4.9, p &lt; 0.0001) fractures were associated with an increased risk of sustaining associated fractures. Only 4.5% of patients sustained multiple fractures after a simple fall, but due to the frequency of falls in the elderly this mechanism resulted in 80.7% of all multiple fractures. Most patients required admission (&gt; 80%), of whom 42% did not need an operation but more than half needed an increased level of care before discharge (54%). The standardised mortality rate at one year was significantly greater after sustaining multiple fractures that included fractures of the pelvis, proximal humerus or proximal femur (p &lt; 0.001). This mortality risk increased further if patients were &lt; 80 years of age, indicating that the existence of multiple fractures after low-energy trauma is a marker of mortality. <\/jats:p>","DOI":"10.1302\/0301-620x.94b2.27381","type":"journal-article","created":{"date-parts":[[2012,2,8]],"date-time":"2012-02-08T20:16:57Z","timestamp":1328732217000},"page":"231-236","source":"Crossref","is-referenced-by-count":35,"title":["Multiple fractures in the elderly"],"prefix":"10.1302","volume":"94-B","author":[{"given":"N. D.","family":"Clement","sequence":"first","affiliation":[{"name":"Royal Infirmary of Edinburgh, 51\rLittle France Crescent, Old Dalkeith Road, Edinburgh EH16\r4SA, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh, 51\rLittle France Crescent, Old Dalkeith Road, Edinburgh EH16\r4SA, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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Seventh ed. Philadelphia: Lippincott, Williams &\n Wilkins, 2010:53\u201377."},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.20.1895"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/30.suppl_4.3"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198812293192604"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2008.12.005"},{"key":"r18","unstructured":"No authors listed. Centre of Disease Control and Prevention: cost of falls among older adults. http:\/\/www.cdc.gov\/homeandrecreationalsafety\/falls\/fallcost.html (date last accessed 7 October 2011)."},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2001.015644"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/55.3.M112"},{"key":"r21","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1315-1"}],"container-title":["The Journal of Bone and Joint Surgery. 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