Jeffrey Chirk Fan Lau1, Ki Wai Ho2, Shahzad Sadiq3. 1. University Hospital of North Staffordshire, Stoke-on-Trent, UK. Electronic address: jlau87@doctors.org.uk. 2. Chinese University of Hong Kong, China. 3. Worcestershire Royal Hospital, Worcester, UK.
Abstract
BACKGROUND: Sequential hip fractures are associated with increased morbidity and mortality. Understanding of risk factors is important for secondary prevention. Although hip fractures have a multifactorial aetiology related to falls, it is unknown whether fracture management approach influences the risk of sequential hip fractures. OBJECTIVES: Our objective is to explore whether subsequent contralateral hip fractures are more common following femoral head replacement or salvage procedures for the treatment of hip fractures. METHODS: Patients older than 50, admitted to a single regional trauma unit in Worcestershire between 2010 and 2012 were identified from the national database. 700 patients matched our inclusion criteria and case notes were reviewed. The male to female ratio was 1:3.3 and the mean age was 82.8 years (standard deviation: 8.9 years). Contralateral fractures were identified from admission X-rays. Risk factors were analysed based on patient demographics and data related to first hip fracture management. RESULTS: Seventy-one patients presented with contralateral fractures, of which 19 had their first fracture during the data collection period, estimating a period prevalence of 10.1%, and incidence of 2.9%. Contralateral fracture rates were not significantly different between femoral head salvage and replacement procedures (P-value 0.683). Older institutionalised females with poorer mobility status were at greatest risk of contralateral hip fractures. Half (50.7%) of these occurred within 2 years of their first fracture. CONCLUSION: No additional risk was seen in either fixation approaches. Risk factors identified were in keeping with existing literature, which can help to identify high-risk groups for targeted prevention strategies.
BACKGROUND: Sequential hip fractures are associated with increased morbidity and mortality. Understanding of risk factors is important for secondary prevention. Although hip fractures have a multifactorial aetiology related to falls, it is unknown whether fracture management approach influences the risk of sequential hip fractures. OBJECTIVES: Our objective is to explore whether subsequent contralateral hip fractures are more common following femoral head replacement or salvage procedures for the treatment of hip fractures. METHODS:Patients older than 50, admitted to a single regional trauma unit in Worcestershire between 2010 and 2012 were identified from the national database. 700 patients matched our inclusion criteria and case notes were reviewed. The male to female ratio was 1:3.3 and the mean age was 82.8 years (standard deviation: 8.9 years). Contralateral fractures were identified from admission X-rays. Risk factors were analysed based on patient demographics and data related to first hip fracture management. RESULTS: Seventy-one patients presented with contralateral fractures, of which 19 had their first fracture during the data collection period, estimating a period prevalence of 10.1%, and incidence of 2.9%. Contralateral fracture rates were not significantly different between femoral head salvage and replacement procedures (P-value 0.683). Older institutionalised females with poorer mobility status were at greatest risk of contralateral hip fractures. Half (50.7%) of these occurred within 2 years of their first fracture. CONCLUSION: No additional risk was seen in either fixation approaches. Risk factors identified were in keeping with existing literature, which can help to identify high-risk groups for targeted prevention strategies.
Authors: Franz Müller; Michael Galler; Michael Zellner; Christian Bäuml; Christina Roll; Bernd Füchtmeier Journal: Eur J Trauma Emerg Surg Date: 2018-07-16 Impact factor: 3.693
Authors: Bayard C Carlson; William A Robinson; Nathan R Wanderman; Arjun S Sebastian; Ahmad Nassr; Brett A Freedman; Paul A Anderson Journal: Geriatr Orthop Surg Rehabil Date: 2019-07-17