The influence of ageing on the incidence and site of trauma femoral fractures: a cross-sectional analysis

Abstract

Background: This study aimed to determine the influence of ageing on the incidence and site of femoral fractures in trauma patients, by taking the sex, body weight, and trauma mechanisms into account. Methods: This retrospective study reviewed data from adult trauma patients aged ≥20 years who were admitted into a Level I trauma center, between January 1, 2009 and December 31, 2016. According to the femoral fracture locations, 3859 adult patients with 4011 fracture sites were grouped into five subgroups: proximal type A (n = 1359), proximal type B (n = 1487), proximal type C (n = 59), femoral shaft (n = 640), and distal femur (n = 466) groups. A multivariate logistic regression analysis was applied to identify independent effects of the univariate predictive variables on the occurrence of fracture at a specific site. A two-dimensional plot was presented visually with age and the propensity score accounts for the risk of a fracture at a specific femoral site. Results: This analysis revealed that older age was an independent variable that could positively predict the occurrence of proximal type A (OR [95%CI]: 1.03 [1.03-1.04], p < 0.001) and B fractures (1.02 [1.01-1.02], p < 0.001), and negatively predict the occurrence of proximal type C (0.96 [0.94-0.98], p < 0.001), shaft (0.95 [0.95-0.96], p < 0.001), and distal fractures (0.98 [0.98-0.99], p < 0.001). Discussion: Using the propensity scores which account for the risk of a fracture in a specific femoral site, this study revealed that the older patients were at a higher risk of developing proximal type A and type B fractures, while a lower risk of developing fractures in the shaft and distal femur. This incidence of fracture site can largely be explained by agerelated factors, including a decrease in bone strength and falling being the most common mechanism of trauma in older patients. Conclusions: This study revealed a difference in the involvement of age in the incidence of femoral fracture sites in the trauma patients.

Trauma workload during COVID19 lockdown: an analysis of incidence in 4 million people

“…This may justify the significant increase of mean patients age between 2019 and 2020 (73.2 vs 83.5 years p = 0.02). According to our opinion and as showed in literature [ 12 ], age is directly related to fracture mechanism: fractures due to bone fragility rather than severe injury are uncommon in young adults [ 13 ]. Locking-down reduced the mobility of mild-elderly patients who are not getting outside their home so much reducing the incidence of their femur fractures.…”

A Novel Closed Reduction Technique for Treating Femoral Shaft Fractures With Intramedullary Nails, Haemostatic Forceps and the Lever Principal

“…Fractures of the femoral shaft are common high-energy injuries of the lower extremities [11]. Because of the thick tissue envelope surrounding the femur, iatrogenic muscle injury and adhesion can be caused by conventional open reduction and internal xation with the plate system [12].…”

Impact of Adapting the Abbreviated Injury Scale (AIS)-2005 from AIS-1998 on Injury Severity Scores and Clinical Outcome

“…The study double-coded the injuries for all 7520 consecutively admitted trauma patients during a three-year period between 1 January, 2016, and 31 December, 2018, by two certified specialists who had been trained for coding and experienced for three and ten years, respectively, in trauma registry at Taiwan. The study hospital is a level I trauma center in the Kaohsiung city, Taiwan [18][19][20] and serves around three millions patients in southern Taiwan with another two level I trauma centers [21][22][23][24]. About thirty thousand trauma patients had visited the emergency department of this hospital and, among them, there were around 3600 hospitalizations per year.…”