Characteristics of Fallers Who Fracture at the Foot, Distal Forearm, Proximal Humerus, Pelvis, and Shaft of the Tibia/Fibula Compared with Fallers Who Do Not Fracture

Theresa H Keegan, Jennifer L. Kelsey, Abby C. King, Charles P. Quesenberry, Stephen Sidney

Research output: Contribution to journalArticle

66 Scopus citations


This case-control study examined the relation of circumstances of falls and characteristics of fallers with risk of fractures at five sites among persons 45 years of age or older from five Kaiser Permanente Medical Centers in Northern California from 1996 to 2001. Included were distal forearm (n = 1,016), foot (n = 574), proximal humerus (n = 467), pelvis (n = 150), and shaft of the tibia/fibula (n = 141) cases who fell at the time of their fracture, and controls (n = 512) who reported falling in the year before the interview but did not fracture. Interviewers collected information by using a standardized questionnaire. Medium-/high-heeled shoes and shoes with a narrow heel increased the risk of all fractures, and slip-on shoes (adjusted odds ratio = 2.3, 95% confidence interval: 1.4, 4.0) and sandals (adjusted odds ratio = 3.1, 95% confidence interval: 1.5, 6.3) increased the risk of foot fractures. Falling from more than a standing height increased the risk of all fractures by two- to fivefold, while breaking the fall was associated with lower risks of all fractures except the distal forearm. Physical activity and hormone therapy were associated with lower risks of most fractures. These results suggest ways in which risks of fractures in older persons can be reduced.

Original languageEnglish (US)
Pages (from-to)192-203
Number of pages12
JournalAmerican Journal of Epidemiology
Issue number2
StatePublished - Jan 15 2004
Externally publishedYes



  • Accidental falls
  • Aging
  • Biomechanics
  • Foot
  • Forearm
  • Fractures
  • Pelvis
  • Shoes

ASJC Scopus subject areas

  • Epidemiology

Cite this