Combined Upper-Lower Extremities Fractures in the Elderly

Age-related bone loss is believed to increase the risk of traumatic fragility fractures in both men and women. We aimed to determine the risk factors associated with simultaneous fractures in the upper-lower extremities. This retrospective study utilized the ACS-TQIP database from 2017 to 2019 to identify patients with respective fractures caused by ground-level falls. A total of 403,263 patients with femur fractures and 7,575 patients with combined upper-lower extremities (humerus-femur) fractures were identified. Patients had higher odds of combined upper-lower extremities fractures with increasing age: 18-64 (OR 1.05, P <.001); 65-74 (OR 1.72, P <.001); and 75-89 (OR 1.90, P <.001) while adjusting for other statistically significant risk factors. Advanced age increases the risk of traumatic combined upper-lower extremities fractures. Prevention strategies should be emphasized to reduce the burden of simultaneous injury in the upper-lower extremities.