Osteoporosis International

, Volume 10, Issue 6, pp 487–494

Differences in Risk Factor Patterns Between Cervical and Trochanteric Hip Fractures

  • K. Michaëlsson
  • E. Weiderpass
  • B. Y. Farahmand
  • J. A. Baron
  • P.-G. Persson
  • L. Zidén
  • C.  Zetterberg
  • S. Ljunghall
  • on behalf of the Swedish Hip Fracture Study Group
Original Article

DOI: 10.1007/s001980050259

Cite this article as:
Michaëlsson, K., Weiderpass, E., Farahmand, B. et al. Osteoporos Int (1999) 10: 487. doi:10.1007/s001980050259

Abstract:

The two types of hip fracture – cervical and trochanteric femoral fractures – are generally considered together in etiologic studies. However, women with a trochanteric fracture may be more osteoporotic than those with cervical hip fractures, and have higher post-fracture mortality. To explore differences in risk factor patterns between the two types of hip fracture we used data from a large population-based case–control study in Swedish women, 50–81 years of age. Data were collected by questionnaire, to which more than 80% of subjects responded. Of the cases included, 811 had had a cervical fracture and 483 a trochanteric fracture during the study period; these cases were compared with 3312 randomly selected controls. Height and hormonal factors appeared to affect the risk of the two types of hip fracture differently. For every 5 cm of current height, women with a cervical fracture had an adjusted odds ratio (OR) of 1.23 (95% CI 1.15–1.32) compared with an OR of 1.06 (95% CI 0.97–1.15) for women with trochanteric fractures. Later menopausal age was protective for trochanteric fractures (OR 0.95, 95% CI 0.91–0.99 per 2 years) but no such association was found for cervical fractures. Compared with never smokers, current smokers had an OR of 1.48 (95% CI 1.12–1.95) for trochanteric fractures and 1.22 (95% CI 0.98–1.52) for cervical fractures. Current hormone replacement therapy was similarly protective for both fracture types, but former use substantially reduced risk only for trochanteric fractures: OR 0.55 (95% CI 0.33–0.92) compared with 1.00 (95% CI 0.71–1.39) for cervical fractures. These risk factor patterns suggest etiologic differences between the fracture types which have to be considered when planning preventive interventions.

Key words: Cervical – Estrogen – Height – Hip fracture – Trochanteric

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 1999

Authors and Affiliations

  • K. Michaëlsson
    • 1
  • E. Weiderpass
    • 2
  • B. Y. Farahmand
    • 3
  • J. A. Baron
    • 4
  • P.-G. Persson
    • 3
  • L. Zidén
    • 5
  • C.  Zetterberg
    • 6
  • S. Ljunghall
    • 7
  • on behalf of the Swedish Hip Fracture Study Group
  1. 1.Department of Surgery, University Hospital, Uppsala, SwedenSE
  2. 2.Department of Medical Epidemiology, Karolinska Institute, Stockholm, SwedenSE
  3. 3.Division of Epidemiology, Karolinska Hospital, Stockholm, SwedenSE
  4. 4.Departments of Medicine and Community & Family Medicine, Dartmouth Medical School, Hanover, New Hampshire, USAUS
  5. 5.Vasa Hospital, Gothenburg, SwedenSE
  6. 6.Department of Orthopedics, Halmstad, Sweden;SE
  7. 7.Department of Medical Sciences, University Hospital, Uppsala, SwedenSE