Evaluation of Risk Factors for Second Hip Fractures in Elderly Patients

Batın, Sabri; Ozan, Fırat; Gürbüz, Kaan; Koyuncu, Şemmi; Vatansever, Fatih; Uzun, Erdal

doi:10.14740/jocmr3287w

Cited by 10 publications

(14 citation statements)

References 23 publications

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“…Furthermore, in the follow-up period, 3.0% of our patients had contralateral hip fractures. Secondary hip fractures reportedly occurred in 2% to 5% of the proximal femoral fracture patients within one year of the initial injury43444546), and the highest risk of secondary hip fractures occurred in the first postoperative year4748). In our study, no patient had a contralateral fracture within 1 year.…”

Section: Discussionmentioning

confidence: 43%

Cementless Bipolar Hemiarthroplasty for Low-energy Intracapsular Proximal Femoral Fracture in Elderly East-Asian Patients: A Longitudinal 10-year Follow-up Study

et al. 2019

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PurposeShort-term outcomes following cemented and cementless hemiarthroplasties (HAs) are reported to be comparable, however, long-term outcomes of cementless HA—especially among Asian patients—is limited. We aimed to assess long-term outcomes in elderly East-Asian patients with intracapsular proximal femoral fractures treated with cementless HA.Materials and MethodsWe enrolled 135 patients treated with cementless HA who met our inclusion criteria. We documented bone/implant-related complications (e.g., incidences of revision hip surgery, femoral stem subsidence, dislocation, intraoperative and postoperative periprosthetic fractures, contralateral hip fractures). We included those patients who are still alive 10 years after the index surgery in the final functional analysis of the existence of pain, ambulatory status, and residential status.ResultsThe mean age at injury was 78.3 years (range: 60–85 years). At the 10-year follow-up, 26 of the original patients (19.3%) had survived. During follow-up, revision hip surgery was conducted in two patients (1.5%). We recorded the incidence of intraoperative fractures, postoperative periprosthetic fractures, and contralateral fractures in two (1.5%), eight (5.9%), and six patients (4.4%), respectively. Among the 10-year survivors, six patients (23.1% of the survivors) complained of groin pain, but generally reported the pain to be tolerable.ConclusionAmong elderly East-Asian patients, the incidence of revision surgery after cementless HA may be lower than that in their European counterparts, whereas the incidence of periprosthetic fractures can still be considerably higher. For patients undergoing cementless HA, prevention of such secondary fractures is of critical importance.

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Section: Discussionmentioning

confidence: 43%

Cementless Bipolar Hemiarthroplasty for Low-energy Intracapsular Proximal Femoral Fracture in Elderly East-Asian Patients: A Longitudinal 10-year Follow-up Study

et al. 2019

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“…Approximately one third of patients with hip fractures have suffered another fragility fracture previously [228]. 7 -15% of patients admitted have a second hip fracture [229][230][231][232][233][234][235][236], with an accumulated incidence of 1.2 -3% in the first year and 9-10% at 8 years [7,[237][238][239][240][241][242][243][244], and can reach over 20% among patients with Alzheimer's disease [245]. Time between hip fracture varies upon study methodology and observation period; some authors state that over half of these occur in the first year after fracture [230,238] while other suggest the median time between hip fractures is over 3 years [232,236].…”

Section: Second Hip Fracturementioning

confidence: 99%

“…Compared to patients who suffer a first hip fracture, patients with second hip fractures are usually female, older, have extracapsular fractures and have poorer baseline mobility [231,233,234,244,251]. Approximately two thirds of patients have the same type of fracture on both occasions [236,252]; proximal femoral morphology may play a role in this phenomenon [252].…”

Section: Second Hip Fracturementioning

confidence: 99%

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Orthogeriatric Care: Reviewing Improvements in Outcomes

Tarazona-Santabalbina¹,

Ojeda-Thies²,

Rodríguez³

et al. 2021

Preprint

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Orthogeriatric co-management units have increased quality of care, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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“…Risk of a second hip fracture following an index hip fracture range from 2% to 13% in various studies, with 50% occurring within the first two years [ 2 , 5 ]. Furthermore, postoperative complications, prolonged hospital stays, reduction in mobility status, and significantly higher mortality rates are seen more frequently with contralateral fractures [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors and Consequences of Consecutive Proximal Femur Fractures in Elderly Patients

Gurusinghe¹,

Navaratnam²,

Weerasinghe³

et al. 2021

Cureus

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BackgroundProximal femur fracture (PFF) carries significant morbidity, mortality, and cost implications to the health system. Subsequent contralateral fracture further decreases patient performance and increases the healthcare burden. This study aimed to identify and evaluate potential risk factors for consecutive PFF. MethodologyPilgrim Hospital PFF database from 2012 to 2019 was retrospectively analyzed. Patients over 60 years with low-energy fractures were included. Pathological and atypical fractures and polytrauma were excluded. ResultsThere were 114 patients (4.18%) with contralateral hip fractures out of a total of 2727 PFF patients; 80% were females. The mean age was 82 years for the first hip fracture and 85 years for the second. The average time interval between fractures was 36 months. The fracture pattern was the same on both sides in 74.3% of patients (P<0.0001). Out of 53 patients with cemented hip hemiarthroplasty (CHH) on one side, 31 patients (59%) had a second CHH for the contralateral side. Likewise, out of 48 patients who had dynamic hip screw fixation during the first admission, 33 patients (69%) had the same procedure on the contralateral side too.During the two consecutive admissions, the length of hospital stay was not significantly different (P=0.30), median American Society of Anesthesiologists (ASA) grades were 3, hyponatremia increased from 25% to 29% (P=0.5), mean decline in abbreviated mental test score (AMTS) was 0.4, deterioration of Clinical Frailty Score and Charlson morbidity index were from 4.5 to 5.9 (P<0.0001), and from 5.4 to 6.1, respectively, and institutional residency was increased from 23 to 46 (P>0.0014). ConclusionThe similarity of fracture pattern bilaterally requiring similar surgical procedures is comparable with other literature. Even though there is minimal or no change in the ASA, AMTS, and hospital stay between the two admissions, there is a significant decline in clinical frailty, mobility status, and an increase in residential dependency following a subsequent fracture. Our findings demonstrate the importance of emphasizing secondary preventive measures to prevent a consecutive fracture.

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Evaluation of Risk Factors for Second Hip Fractures in Elderly Patients

Cited by 10 publications

References 23 publications

Cementless Bipolar Hemiarthroplasty for Low-energy Intracapsular Proximal Femoral Fracture in Elderly East-Asian Patients: A Longitudinal 10-year Follow-up Study

Cementless Bipolar Hemiarthroplasty for Low-energy Intracapsular Proximal Femoral Fracture in Elderly East-Asian Patients: A Longitudinal 10-year Follow-up Study

Orthogeriatric Care: Reviewing Improvements in Outcomes

Analysis of Risk Factors and Consequences of Consecutive Proximal Femur Fractures in Elderly Patients

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