Characteristics and outcome in patients sustaining a second contralateral fracture of the hip

Abstract

We compared 5341 patients with an initial fracture of the hip with 633 patients who sustained a second fracture of the contralateral hip. Patients presenting with a second fracture were more likely to be institutionalised, female, older, and have lower mobility and mental test scores. There was no significant difference between the two groups with regards to the change in the level of mobility or return to their original residence at one year follow-up. However, the mortality rate in the second fracture group was significantly higher at one year (31.6% vs 27.3%, p = 0.024). In two thirds of patients, the second fracture was in the same anatomical location as the first. In an analysis of 293 patients, approximately 70% of second fractures occurred within three years of the first. This is the largest study to investigate the outcome of patients who sustain a second contralateral hip fracture. Despite the higher mortality rate at one year, the outcome for surviving patients is not significantly different from those after initial hip fractures.

Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database

“…[11,12] We found significantly higher risk in females with univariate analysis, but there were no statistical significance seen with multivariate analysis. The results of the survival analysis confirm the fact that females have longer survival, which may explain their higher risk of second hip fracture.…”

Ellenoldali csípőtáji törésekkel összefüggő halálozás és kockázati tényezőinek vizsgálata

“…Berry és mtsai [28] az első csípőtáji törésnél 15,9%-os, a következő csípőtáji törésnél 24,1%-os egy éven belüli halálozást igazoltak. Sawalha és Parker [29] a primer csípőtáji törés egy éven belüli halálozását 27,3%-nak, az ellenoldali szekunder csípőtáji törésekét szignifikánsan (p = 0,024) magasabbnak, 31,6%-nak találták. Skála-Rosenbaum és mtsai [17] meglepő eredményre jutottak, miszerint az egy éven belüli halálozás a csak egyoldali csípőtáji törött betegeknél 27,9%, míg az ellenoldali csípőtáji törést szenvedett betegeknél 22% (p<0,001).…”

Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients

“…The latter is associated with an increased mortality risk; the one-year mortality ranges from 9 % to 27% following a first hip fracture and 8% to 32% after a second hip fracture (2,13,14).…”

“…The reported interval between both fractures is 2-5 years (2-4, 6, 13, 15, 18, 21, 22). In 60-81% of the patients with bilateral hip fractures the second fracture is of the same type as the first hip fracture (i.e., trochanteric or femoral neck) (3,4,13,14,18,21,23). Most reports on characteristics of bilateral hip fractures involved patients with both trochanteric and femoral neck fractures.…”

“…A minority of patients with a primary trochanteric fracture sustains a subsequent contralateral femoral neck fracture. The opposite, a femoral neck fracture as a second fracture with a first trochanteric fracture, is even rarer (14,17). Especially the treatment of non-simultaneous femoral neck fractures has received little attention in previous studies.…”