Epidemiology of cervical and trochanteric fractures of the proximal femur in 1994 in Tangshan, China

Abstract

The purpose of this study was to determine the incidence of cervical and trochanteric fractures of the proximal femur in 1994 in Tangshan City, China. There are many reports on hip fracture incidence in many countries, suggesting that there are many factors affecting hip fractures. We visited 15 hospitals with an orthopaedic department within Tangshan City, and reviewed the medical records and radiographs of all patients with hip fractures occurring between January 1 and December 31, 1994. The population of Tangshan in 1994 was determined to be 1,454,543 (746,015 males and 708,528 females). The population of those over 65 years of age was 88,490 (41,519 males and 46,971 females), representing 6.08% of the total population. This study detected 184 cervical and trochanteric fractures of the proximal femur in 1994 in Tangshan (127 men and 57 women). The overall incidence or rate of the combined number of cervical and trochanteric fractures was 25 fractures per 100,000 population per year for men and 12 for women. There were a total of 147 cervical fractures (80%) and 37 trochanteric fractures (20%). The incidence of the combined number of cervical and trochanteric fractures in patients over 70 years of age increased to 108 for men and 156 for women. The incidence of hip fractures increased with age in both sex groups, especially in women over 65. Severe trauma fractures happened more often in younger groups, and mainly occurred in men, which may be a result of the particular composition of the population in Tangshan, which is young and male dominated. In addition, because Tangshan is an industrial city, many of its citizens are involved in occupations requiring a high level of physical activity.

The relative importance of genetics and phenotypic plasticity in dictating bone morphology and mechanics in aged mice: Evidence from an artificial selection experiment

“…Because of its lower cross-sectional area and moments of inertia, coupled to large bending moments, the femoral neck could be expected to be the most likely site of fracture. This prediction is supported by studies in humans and other mammals (Crawford and Fretz, 1985;Embertson et al, 1986;Zhang et al, 2000;Harasen, 2003) and our experimental results: all femora fractured proximally at the neck, rather than in the shaft.…”

“…Right femora were used for morphometric measurements and mechanical testing, and left femora were scanned using microcomputed tomography (µCT). The femur was chosen for detailed study because it is subject to the most direct loading from the axial skeleton, and the proximal femur is the site of most femoral fractures (Crawford and Fretz, 1985;Embertson et al, 1986;Zhang et al, 2000;Harasen, 2003).…”

Geographic trends in incidence of hip fractures: a comprehensive literature review

“…In Asia, we found that rates from Hong Kong [25,51] and Taiwan [47] tended to be among the highest, whereas studies from mainland China [25,59,60] were among the lowest. Interestingly, Middle Eastern countries had both the highest (Shiraz, Iran [58]) and lowest (Beirut, Lebanon [45]) rates in Asia.…”

Hip fractures in the Portuguese archaeological record

“…In modern epidemiological studies, intracapsular fractures are generally more common than extracapsular fractures (Kannus et al, 1996;Michaëlsson et al, 1999;Zhang et al, 2000), but not always (Maghraoui et al, 2005). These two types of hip fracture are usually considered together in aetiological studies (Michaëlsson et al, 1999).…”