FALL BIOMECHANICS AND OSTEOPOROTIC FRACTURE OCCURRENCE AT THE PROXIMAL FEMUR - IMPLICATIONS FOR THE PREVENTION OF FALL-RELATED INJURIES

Age-related fractures are considered to be primarily the consequence o f bone loss and increased bone fragility. In line with this dominant v iew on fracture etiology, prevention studies have primarily focused on pharmacological interventions to increase bone density of the femoral neck. However, osteoporotic fracture occurrence is not entirely accou nted for by bone strength but also related to the incidence and impact of falls. Recent data have provided evidence that an intensive multif actorial intervention strategy can be used to decrease the incidence o f falls, but it remains to be determined whether fall prevention can b e used successfully to prevent fall-related injuries or hip fracture. In fact, while more than 90% of hip fractures involve falls, hip fract ure occurs in only about 1% of falls, suggesting that falls that cause hip fracture may differ qualitatively from other falls. Fall severity , rather than fall initiation, may therefore have to be the primary su bject of future research.