Incidence of fractures on the distal radius and proximal femur: comparison of patients in a mental hospital and the general population.

A statistically significant increase in the incidence of fractures of the distal radius was found in the general population of southern Sweden during recent decades. As regards fractures of the proximal femur, an increase in the incidence of trochanteric fractures was observed only in women. In male patients at a mental hospital the fracture rate of the distal radius was the same as in the general population but the fracture rate of the proximal femur was about twelve times higher. In female patients at the same mental hospital the fracture rate of the distal radius was three times greater and that of proximal femur about seven times greater than that of the general population. This difference may not only be due to an increased skeletal fragility in patients in mental institutions but may also suggest poorer protective mechanisms against falls. Undiagnosed cardiovascular or neurological diseases, for example intermittent cardiac arrhythmia or transient cerebral ischaemic attacks, may cause falls. Early diagnosis and treatment of such diseases may reduce the number of fractures of the proximal femur.