Importance of raising awareness about spontaneous insufficiency fractures in the bedridden elderly

imaging, systematic assessments of prevalence and outcome of such fracture have not been carried out. Most cases are reported as case series reports, with only a few epidemiological studies conducted to date. Yearly incidence of insufficiency fractures in the institutionalized elderly was reported to be approximately 0.84 per 100 patients [3]. In Japan, an observational study was conducted during 1998–2004 of patients in a long-term care facility. During the 6-year follow-up period, 18 patients, or 3.6% of 500 bedridden patients, suffered spontaneous insufficiency fracture. Fracture sites were femur (12), humerus (five) and proximal phalanx (one). All insufficient fractures occurred near joint contractures [4]. A 30-month prospective observation cohort study in France was conducted among nursing home residents aged 65 years and older. Prevalence of long bone insufficiency fracture was 1% among patients admitted to a long-term nursing home. Overall mortality after fracture at 2 months was 24%, with the poorest outcome observed in the shaft fracture group, which showed mortality of 54% at two months [5].