The Risk of a Second Hip Fracture in Patients after Their First Hip Fracture

Abstract

We investigated the incidence of additional fractures and the rate of prescription of osteoporotic pharmacotherapy after an initial hip fracture. We surveyed female patients aged 65 and over who sustained their first hip fracture between January 1, 2006, and December 31, 2007, treated at 25 hospitals in five geographic areas in Japan. Data for 1 year after the first hip fracture were collected from medical records, and questionnaires were mailed to all patients. In total, 2,663 patients were enrolled, and 335 patients were excluded based on exclusion criteria. The analysis was performed on 2,328 patients. During the 1-year follow-up period 160 fractures occurred in 153 patients and 77 subsequent hip fractures occurred in 77 patients. The incidence of all additional fractures among patients who sustained their first hip fracture was 70 (per 1,000 person-year) and that for second hip fracture was 34. In comparison to the general population, women ≥65 years of age who sustained an initial hip fracture were four times as likely to sustain an additional hip fracture. Antiosteoporosis pharmacotherapy was prescribed for 436 patients (18.7%), while 1,240 patients (53.3%) did not receive any treatment during the 1-year period. Patients who have sustained one hip fracture have a higher risk of a second hip fracture compared to the general population, and most of these women receive no pharmaceutical treatment for osteoporosis.

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

“…Approximately a quarter of patients had already had a fracture in their medical history, prior to their femoral neck fracture (28%), which corresponds with a previous study on non-simultaneous bilateral femoral neck fractures (30%) (16). These results emphasize the vulnerability of this population, as a prior fracture increases the risk of a hip fracture and the occurrence of a first hip fracture increases the risk of subsequent (hip) fracture (5,23). In the growing, fragile population that often suffers from multiple risk factors for falling and sustaining subsequent fractures, there might be great potential for multidisciplinary secondary prevention strategies.…”

“…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.…”

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

“…The majority of patients (1,586) (Table II). No differences were observed regarding the number of groups in terms of accompanying diseases, type of primary fracture or hospital providing treatment for primary fracture (Table II).…”

“…[1] The incidence of second hip fractures presents an alternating picture. Some found that it is 2.7% at one year and 7.8% at 8.5 years, [2] others present 5 to 10%, [3] while others conclude that the cumulative incidence is 9% after a year and 20% after five years.…”

Rate of Contralateral Hip Fracture After Dynamic Hip Screw Vs Intramedullary Nail for Treatment of Pertrochanteric Hip Fractures

“…Current reports also indicate that the older the patients, the more likely they are to sustain both an index fracture and a subsequent hip fracture (24,25). Overall, the median age of our cohort at the time of their initial hip fracture was 82.4 years for both the HSSP and CMN group; the median age of the cohort that sustained a contralateral fracture at the time of their initial hip fracture was 81.8 years.…”