Osteoporosis International

, Volume 17, Issue 9, pp 1353–1357 | Cite as

Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study

  • T. Nymark
  • J. M. Lauritsen
  • O. Ovesen
  • N. D. Röck
  • B. Jeune
Original Article

Abstract

Introduction

Hip fracture patients represent a frail group of elderly with increased morbidity and mortality. The aim of this study was to evaluate the occurrence and distribution of a second hip fracture in the time interval between the first and the second hip fracture.

Methods

All incident hip fractures in residents of Funen County, Denmark, from 1994 through 2004 were recorded. Verified fractures were sequenced within each patient using the unique Danish identification numbers.

Results

In total, 9990 incident hip fractures occurred: 9122 first hip fractures and 868 (8.7%) second fractures. Within the first year after the first hip fracture, the incidence rate of the second fracture in men decreased from 73 per 1000 person-years (py) during the first 3 months to 8 per 1000 py at 12 months; in women, it decreased from 116 per 1000 py during the first 3 months to 15 per 1000 py at 12 months. Of all the second fractures, 50% occurred within 12 months in men and within 19 months in women.

Conclusions

Few hip fracture patients experience a second hip fracture and when they do, it is within a short time-frame from the first. The risk of sustaining a second hip fracture is high during the first 12 months following the first hip fracture, decreasing to a level equal to or below the incidence of the first hip fracture after this 12-month period. Preventive strategies at the time of the first hip fracture should therefore aim at immediate effects, as interventions with effects after 12 months (men) and 19 months (women) bypass at least 50% of the fractures.

Keywords

Database study Epidemiology Hip fracture Subsequent fracture Time-frame 

References

  1. 1.
    Gillespie LD, Gillespie WJ, Robertson MC et al (2003) Interventions for preventing falls in elderly people. Cochrane Database Syst Rev: CD000340Google Scholar
  2. 2.
    Donaldson MG, Khan KM, Davis JC et al (2005) Emergency department fall-related presentations do not trigger fall risk assessment: a gap in care of high-risk outpatient fallers. Arch Gerontol Geriatr 41:311–317PubMedCrossRefGoogle Scholar
  3. 3.
    Salter AE, Khan KM, Donaldson MG et al (2006) Community-dwelling seniors who present to the emergency department with a fall do not receive Guideline care and their fall risk profile worsens significantly: a 6-month prospective study. Osteoporos Int (DOI: 10.1007/s00198-005-0032-7) Google Scholar
  4. 4.
    Harrington JT, Broy SB, Derosa AM et al (2002) Hip fracture patients are not treated for osteoporosis: a call to action. Arthritis Rheum 47:651–654PubMedCrossRefGoogle Scholar
  5. 5.
    Formiga F, Rivera A, Nolla JM et al (2005) Failure to treat osteoporosis and the risk of subsequent fractures in elderly patients with previous hip fracture: a five-year retrospective study. Aging Clin Exp Res 17:96–99PubMedGoogle Scholar
  6. 6.
    Andrade SE, Majumdar SR, Chan KA et al (2003) Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 163:2052–2057PubMedCrossRefGoogle Scholar
  7. 7.
    Melton LJ, Ilstrup DM, Beckenbaugh RD et al (1982) Hip fracture recurrence. A population-based study. Clin Orthop 131–138Google Scholar
  8. 8.
    Chiu KY, Pun WK, Luk KD et al (1992) Sequential fractures of both hips in elderly patients-a prospective study. J Trauma 32:584–587PubMedGoogle Scholar
  9. 9.
    Schroder HM, Petersen KK, Erlandsen M (1993) Occurrence and incidence of the second hip fracture. Clin Orthop 166–169Google Scholar
  10. 10.
    Dretakis KE, Dretakis EK, Papakitsou EF et al. (1998) Possible predisposing factors for the second hip fracture. Calcif Tissue Int 62:366–369PubMedCrossRefGoogle Scholar
  11. 11.
    Weatherall M (1999) Contralateral fracture of the proximal femur. Implications for planning trials. J Bone Joint Surg Br 81:77–79PubMedCrossRefGoogle Scholar
  12. 12.
    Wolinsky FD, Fitzgerald JF (1994) Subsequent hip fracture among older adults. Am J Public Health 84:1316–1318PubMedCrossRefGoogle Scholar
  13. 13.
    Shabat S, Gepstein R, Mann G et al. (2003) The second hip fracture – an analysis of 84 elderly patients. J Orthop Trauma 17:613–617PubMedCrossRefGoogle Scholar
  14. 14.
    Pearse EO, Redfern DJ, Sinha M et al (2003) Outcome following a second hip fracture. Injury 34:518–521PubMedCrossRefGoogle Scholar
  15. 15.
    Nymark T, Lauritsen J, Ovesen O et al (2006) Decreasing incidence of hip fracture in the Funen County. Denmark Acta Orthopaedica 77:109–114CrossRefGoogle Scholar
  16. 16.
    WHO (1992) ICD-10: International statistical classification of diseases and related health problems, 10th revision. World Health Organization, GenevaGoogle Scholar
  17. 17.
    NOMESCO (2004) Classification of Surgical Procedures, Version 1.8. Nordic Medico-Statistical Committee, Copenhagen, DenmarkGoogle Scholar
  18. 18.
    Statistics Denmark (24-2-2006) Declaration of contents: The population 1. January, the movements and the population in the municipalities and regions. http://www.dst.dk/HomeUK/Guide/documentation/Varedeklarationer/emnegruppe/emne.aspx?sysrid=000757 Data File
  19. 19.
    Central Office of Civil Registration. (27-9-2001) The Civil Registration System in Denmark. http://www.cpr.dk/Index/dokumenter.asp?o=7&n=0&h=7&t=1&d=141&s=5 Data File
  20. 20.
    Statistics Denmark (12-12-2005) Migration between counties 1994-2004. http://www.statbank.dk/FLY5 Data File
  21. 21.
    Sheehan J, Mohamed F, Reilly M et al (2000) Secondary prevention following fractured neck of femur: a survey of orthopaedic surgeons practice. Ir Med J 93:105–107PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  • T. Nymark
    • 1
    • 2
  • J. M. Lauritsen
    • 1
    • 3
  • O. Ovesen
    • 1
  • N. D. Röck
    • 1
  • B. Jeune
    • 3
  1. 1.Department of OrthopaedicsOdense University HospitalOdense CDenmark
  2. 2.Institute of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark
  3. 3.Institute of Public HealthUniversity of Southern DenmarkOdense CDenmark

Personalised recommendations