ABSTRACT
Fractures in the elderly are increasing in incidence very rapidly and are becoming a major socio-economic problem in most countries. Fractures which were possibly osteoporotic have been found in Egyptian mummies and in skeletons from the Middle Ages in England. Accurate analyses of fracture incidence are surprisingly difficult to find in the literature for a number of reasons. The epidemiology of fractures in the elderly has unfortunately been largely ignored by orthopaedic surgeons who have concentrated mainly on high energy injuries in younger patients. The literature strongly suggests that scapula fractures result from high energy injuries and occur in young adults. There is a view among some orthopaedic surgeons that femoral diaphyseal fractures are high energy injuries. Fracture of the distal femur, like femoral diaphyseal fracture, used to be assumed to be a high energy injury, but is a fragility fracture, particularly in females. Tibia and fibula diaphyseal fractures are unusual, in that their incidence is falling.
