Is contralateral femoral neck-shaft angle predictive of timing of subsequent hip fracture?

Abstract

IntroductionIn 2019, research showed that in the six acute adult Dublin hospitals, 1 in 11 patients with fragility hip fracture sustained a second contralateral hip fracture. These have implications of additional patient morbidity and cost to the health service. Relationship of the contralateral femoral neck-shaft angle (NSA) and timing to the second hip fracture have not been established previously. Our study aimed to establish the relationship of the contralateral femur NSA in patient who already sustained a fragility hip fracture and determine if we could predict the timing of the second hip fracture.MethodsA 7 year single institution retrospective cohort study of patients that presented with second fragility hip fracture from 2013-2019 were reviewed. Exclusion criteria are patients who were aged less than 60 years old, high energy injuries, or had a peri-prosthetic fractures. Plain films anteroposterior (AP) pelvis radiographs were reviewed on the National Integrated Medical Imaging System (NIMIS) McKessons. NSA of the contralateral hip prior to second hip fracture were measured with a standardized method with the TraumaCAD software. Correlation analysis performed with Stata SE statistical software.Results and discussionContralateral NSA is not statistically significant in predicting the timing to second hip fracture. Causes of fragility hip fracture and subsequent second hip fracture are multifactorial and multidisciplinary approach such as fracture liaison services are essential to improve the prevention and treatment of such injuries.