Michael T Wang1, Sarah H Yao2, Phillip Wong3,4,5, Anne Trinh3,4,5, Peter R Ebeling3,4, Ton Tran6, Frances Milat3,4,5, Nora Mutalima6,7. 1. Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia. WangTMichael@gmail.com. 2. Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia. 3. Department of Endocrinology, Monash Health, Clayton, Australia. 4. Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia. 5. Hudson Institute for Medical Research, Clayton, Australia. 6. Department of Orthopaedic Surgery, Monash Health (Dandenong Hospital), Dandenong, Australia. 7. Department of Surgery, Monash University, Clayton, Australia.
Abstract
This study characterises risk factors, complications and follow-up of minimal trauma hip fractures in young adults, adding to limited information examining the management framework. This group have severe systemic disease and significant risk of post-operative complications and subsequent fractures. Improved medical referral pathways enable management of osteoporosis and comorbid diseases. AIMS: There is a paucity of literature examining minimal trauma hip fractures in young adults, despite extensive management guidelines for older patients. This study aims to characterise risk factors, complications and follow-up of hip fractures to guide management pathways. METHODS: This is a retrospective study of patients presenting with hip fracture to a single institution from 2009 to 2015. Hip fractures were identified using ICD-10 codes and clinical information documented from medical records. Patients were categorised into minimal trauma (MTF) and high-energy fracture (HEF) groups based on mechanism of injury. RESULTS: Of 2512 patients admitted with hip fracture, 2.5% (n = 62) were aged 15-49 years. Two patients were excluded with pathological fractures, and seven were excluded with no recorded mechanism of injury. MTF occurred in 43 patients and 10 sustained HEF. These groups had similar demographics, fracture locations and treatments. The MTF group had higher American Society of Anaesthesiologists scores (MTF 2.44 ± 0.9; HEF 1.43 ± 0.5; p = 0.025) and higher rates of chronic endocrine disease (MTF 34.9%; HEF 0%; p = 0.046). Rates of post-operative surgical (MTF 24.0%; HEF 12.5%) and medical complications (MTF 27.8%; HEF 12.5%) were high in MTF patients. Subsequent fractures occurred in five (13.9%) MTF patients during the study period compared with none in the HEF group. Only 16 (44.4%) of the MTF patients were referred to endocrine care. CONCLUSION: Young adults with MTF of the hip have more severe systemic disease and are at risk of post-operative complications and subsequent fractures. Referral of patients to endocrine care is recommended to manage osteoporosis and comorbid diseases.
This study characterises risk factors, complications and follow-up of minimal trauma hip fractures in young adults, adding to limited information examining the management framework. This group have severe systemic disease and significant risk of post-operative complications and subsequent fractures. Improved medical referral pathways enable management of osteoporosis and comorbid diseases. AIMS: There is a paucity of literature examining minimal trauma hip fractures in young adults, despite extensive management guidelines for older patients. This study aims to characterise risk factors, complications and follow-up of hip fractures to guide management pathways. METHODS: This is a retrospective study of patients presenting with hip fracture to a single institution from 2009 to 2015. Hip fractures were identified using ICD-10 codes and clinical information documented from medical records. Patients were categorised into minimal trauma (MTF) and high-energy fracture (HEF) groups based on mechanism of injury. RESULTS: Of 2512 patients admitted with hip fracture, 2.5% (n = 62) were aged 15-49 years. Two patients were excluded with pathological fractures, and seven were excluded with no recorded mechanism of injury. MTF occurred in 43 patients and 10 sustained HEF. These groups had similar demographics, fracture locations and treatments. The MTF group had higher American Society of Anaesthesiologists scores (MTF 2.44 ± 0.9; HEF 1.43 ± 0.5; p = 0.025) and higher rates of chronic endocrine disease (MTF 34.9%; HEF 0%; p = 0.046). Rates of post-operative surgical (MTF 24.0%; HEF 12.5%) and medical complications (MTF 27.8%; HEF 12.5%) were high in MTFpatients. Subsequent fractures occurred in five (13.9%) MTFpatients during the study period compared with none in the HEF group. Only 16 (44.4%) of the MTFpatients were referred to endocrine care. CONCLUSION: Young adults with MTF of the hip have more severe systemic disease and are at risk of post-operative complications and subsequent fractures. Referral of patients to endocrine care is recommended to manage osteoporosis and comorbid diseases.
Entities:
Keywords:
Adult; Follow-up; Fracture; Hip; Minimal trauma; Neck of femur; Osteoporosis; Young
Authors: Adam Omari; Christian Medom Madsen; Jes Bruun Lauritzen; Henrik Løvendahl Jørgensen; Fie Juhl Vojdeman Journal: Int Orthop Date: 2019-03-23 Impact factor: 3.075
Authors: Marko T Korhonen; Urho M Kujala; Jyrki Kettunen; Olga V Korhonen; Jaakko Kaprio; Seppo Sarna; Timo Törmäkangas Journal: J Bone Miner Res Date: 2022-07-06 Impact factor: 6.390