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Trauma

THE SECOND HIP FRACTURE IN THE ELDERLY

European Federation of National Associations of Orthopaedics and Traumatology (EFORT) - 12th Congress



Abstract

INTRODUCTION

In recent years the age of world's population has risen and with it there has been a significant increase in the frequency of hip fractures in the elderly. These fractures are known to increase morbidity and mortality. However, little is known about the frequency and characteristics of patients who sustain a second hip fracture. We examined the incidence and the underlying associated medical disorders of patients with a second fracture in the other hip.

MATERIAL & METHODS

This study consists of 132/1208 Pts. (10.9%) treated in our department between 1998–2006 that had a secondary hip fracture 1–9 years following the first hip fracture. We examined the most common complications following surgery of this type, the most common related illnesses among these patients, and the influence of post-surgical rehabilitative care on the patients' return to daily functioning.

RESULTS

132 Pts (10.9%) of this series (34 M, 98 F; 64–101 year old; mean 81Y) had a second hip fracture. Most of them (82%) had chronic associated disorders such as heart problems, dementia, old CVA, sight problems and renal failure. Of those with a second hip fracture- 9/132 (6.8%) had the second hip fracture within the first year following surgery, 35/132 (26.5.3%) after 2 years and the remaining 102/132 (66.7%) after 3–6 years. 70.8% of the second hip fracture were of the same type and location of the first hip fracture. 65% of the single hip-fracture patients returned to the same type of daily functioning that they had had prior to injury within one year following surgery. 52% of the patients with the second hip fracture returned to the same level of daily functioning they had had during the period between the first and the second hip fracture Furthermore, we also found that sub-capital fractures are more characteristic of a younger population than are intertrochanteric fractures.

DISCUSSION

Based on this study it seems that the frequency of a second fracture in the other hip was 10.9%. The length of time between occurrence of the first and second fractures ranged from one to six years, a third of them within the first 2 years and two thirds of them after 3–6 years. Age and medical status of the patient may be important predictors of a second hip fracture. It is therefore imperative to improve bone quality, medical and functional status of the patients following the first hip fractures in order to reduce the risk of the second hip fractures.