Archives of Orthopaedic and Trauma Surgery

, Volume 127, Issue 3, pp 179–183 | Cite as

Epidemiology of hip fractures in Belgrade, Serbia Montenegro, 1990–2000

  • A. Lešić
  • M. Jarebinski
  • T. Pekmezović
  • M. Bumbaširević
  • D. Spasovski
  • Henry D. E. Atkinson
Trauma Surgery

Abstract

Introduction

This study retrospectively determined the incidence rates of hip fractures in Belgrade, Serbia and Montenegro, during the period 1990–2000.

Materials and methods

All patients with hip fractures treated at all Belgrade hospitals were identified from the Republic of Serbia’s Ministry of Health National Health Care database. Patient demographics, type of hip fracture, and details of the mechanism of injury were collected. The annual incidence rates were calculated with interpolation according to the Belgrade population census of 1991 and 2002.

Results

There were a total of 8,904 hip fractures with a mean annual incidence of 51.7 per 100,000 adults (62.2 females and 35.5 males). Mean age at the time of fracture was 67 years (72.6 for females and 59.3 for males), with 64.7% of all fractures occurring in women. There was a significant increase in hip fracture incidence rates over the observed period in females (P = 0.006), but not in males (P = 0.962). Trochanteric fractures predominated, accounting for 53% compared with cervical fractures. In patients over 50 years of age there was an exponential increase in the incidence of hip fractures in both sexes; though more so in females. 91% of hip fractures occurred in these older patients with incidence rates of 143.6 per 100,000 (185.9 for female and 92.2 for male patients). The most common mechanism of injury in the older group was low-energy trauma (70.3%) resulting from a fall from standing height onto a flat surface (same level). Standardizing incidence rates in the older age group to the US 1985 white population gave values of 228 per 100,000 females and 96 per 100,000 males. These incidence rates are similar to those reported in Italy, France and Great Britain, but lower than those in Scandinavian countries.

Conclusion

In view of growing population numbers and an increase in the proportion of patients aged over 60 years, we can expect an increase in the prevalence of osteoporosis and an increase in the incidence of fragility hip fractures in the future, with resource implications.

Keywords

Hip fractures Epidemiology Belgrade Serbia Montenegro 

References

  1. 1.
    Lidgren L (2003) The bone and joint decade 2000–2010. Bull World Health Organ 81(9): 629PubMedGoogle Scholar
  2. 2.
    Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9): 646–656PubMedGoogle Scholar
  3. 3.
    Kannus P, Niemi S, Parkkari J, Vuori I, Arvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353: 802–805PubMedCrossRefGoogle Scholar
  4. 4.
    Melton LJ III (1996) Epidemiology of hip fractures: implications of the exponential increase with age. Bone 18(3): 121S–125SPubMedCrossRefGoogle Scholar
  5. 5.
    Lau EM, Cooper C (1996) The epidemiology of osteoporosis. The oriental perspective in a world context. Clin Orthop Relat Res 323: 65–74PubMedCrossRefGoogle Scholar
  6. 6.
    Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5): 407–413PubMedCrossRefGoogle Scholar
  7. 7.
    Maggi S, Kelsey JL, Litvak J, Heyse SP (1991) Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1: 232–241PubMedGoogle Scholar
  8. 8.
    Memon A, Pospula WM, Tantawy AY, Abdul-Ghafar S, Suresh A, Al-Rowaih A (1998) Incidence of hip fracture in Kuwait. Int J Epidemiol 27: 860–865PubMedCrossRefGoogle Scholar
  9. 9.
    Zhang L, Cheng A, Bai Z, Lu Y, Endo N, Dohmae Y, Takahashi HE (2000) Epidemiology of cervical and trochanteric fractures of the proximal femur in 1994 in Tangshan, China. J Bone Miner Metab 18(2): 84–88PubMedCrossRefGoogle Scholar
  10. 10.
    Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BE (1979) Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 32(3): 540–549PubMedGoogle Scholar
  11. 11.
    Johnell O, Gullberg E, Allander J, Kanis A (1992) The apparent incidence of hip fracture in Europe: a study of national register sources. Osteoporos Int 2: 298–302PubMedCrossRefGoogle Scholar
  12. 12.
    Bureau of the Census, Current Population Reports p25/1095 (1993) US population estimated by age, sex, race and hispanics origin 1980–1991. US Government Printing Office, Washington Google Scholar
  13. 13.
    Hennekens CH, Buring JE (1987) Epidemiology in medicine. Little, Brown and Company, Boston, 254–256Google Scholar
  14. 14.
    Rogmark C, Sernbo I, Johnell O, Nilsson JA (1999) Incidence of hip fractures in Malmo, Sweden, 1992–1995. A trend-break. Acta Orthop Scand 70(1): 19–22PubMedGoogle Scholar
  15. 15.
    Lofthus CM, Osnes EK, Falch JA, Kaastad TS, Kristiansen IS, Nordsletten L, Stensvold I, Meyer HE (2001) Epidemiology of hip fractures in Oslo, Norway. Bone 29(5): 413–418PubMedCrossRefGoogle Scholar
  16. 16.
    Lizaur-Utrilla A, Puchades Orts A, Sanchez del Campo F, Anta Barrio J, Gutierrez Carbonell P (1987) Epidemiology of trochanteric fractures of the femur in Alicante, Spain, 1974–1982. Clin Orthop Relat Res 218: 24–31PubMedGoogle Scholar
  17. 17.
    Falch JA, Kastad TS, Bohler G, Espeland J, Sundsvold OJ (1993) Secular increase and geographical difference in hip fracture incidence in Norway. Bone 14(4): 643–645PubMedCrossRefGoogle Scholar
  18. 18.
    Rowe SM, Yoon TR, Ryang DH (1993) An epidemiological study of hip fracture in Honam, Korea. Int Orthop 17(3): 139–143PubMedCrossRefGoogle Scholar
  19. 19.
    Elffors L, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Lopes Vaz AA, Lyritis G, et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporos Int 4(5): 253–263PubMedCrossRefGoogle Scholar
  20. 20.
    Xue X, Zhao, Wen ZA, Bai J, Chen X (1992) Dietary survey of the elderly in selected areas of China. Age Nutrition 3: 78–81Google Scholar
  21. 21.
    Kaastad TS, Meyer HE, Falch JA (1998) Incidence of hip fractures in Oslo, Norway: differences within the city. Bone 22(2): 175–178PubMedCrossRefGoogle Scholar
  22. 22.
    Mazzuoli GF, Genarri C, Passeri M, Celi FS, Acca M, Camporeale A, Pioli G, Pedrazzoni M (1993) Incidence of hip fracture: an Italian survey. Osteoporos Int (1 suppl): S8–S9Google Scholar
  23. 23.
    Yan L, Zhou B, Prentice A, Wang X, Golden MH (1999) Epidemiological study of hip fractures in Shenyang, Peoples Republic of China. Bone 24(2): 151–155PubMedCrossRefGoogle Scholar
  24. 24.
    Melton LJ, Ilshop DM, Riggs BZ, Backenbaugh RD (1982) Fifty-year trend in hip fracture incidence. Clin Orthop Relat Res 162: 144–149PubMedGoogle Scholar
  25. 25.
    Spector TD, Cooper C, Lewis AF (1990) Trends in admissions for hip fracture in England and Wales, 1968–1985. Br Med J 300: 1173–1174CrossRefGoogle Scholar
  26. 26.
    Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a worldwide projection. Osteoporos Int 2(6): 285–289PubMedCrossRefGoogle Scholar
  27. 27.
    Nungu S, Olerud C, Rehnberg L (1993) The incidence of hip fracture in Uppsala County. Change of time trend in women. Acta Orthop Scand 64(1): 75–78PubMedCrossRefGoogle Scholar
  28. 28.
    Huusko TM, Karppi P, Avikainen V, Kautiainen H, Sulkava R (1991) The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 year in Central Finland. Bone 24(3): 257–259CrossRefGoogle Scholar
  29. 29.
    Cooper C, Barker DJ, Morris J, Briggs RS (1987) Osteoporosis, falls, and age in fracture of the proximal femur. Br Med J 295: 13–15Google Scholar
  30. 30.
    Gallagher JC, Melton LJ, Riggs BL, Bergstrath E (1980) Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res 150: 163–171PubMedGoogle Scholar
  31. 31.
    Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332: 767–773PubMedCrossRefGoogle Scholar
  32. 32.
    Carter ND, Kannus P, Khan KM (2001) Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Med 31(6): 427–438PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • A. Lešić
    • 1
  • M. Jarebinski
    • 2
  • T. Pekmezović
    • 2
  • M. Bumbaširević
    • 1
  • D. Spasovski
    • 1
  • Henry D. E. Atkinson
    • 3
    • 4
  1. 1.Institute for Orthopaedic Surgery and TraumatologyBelgrade School of Medicine, Clinical Centre of SerbiaBelgradeSerbia Montenegro
  2. 2.Institute for EpidemiologyBelgrade School of MedicineBelgradeSerbia Montenegro
  3. 3.Department of Orthopaedic Surgery and TraumatologyImperial College Medical School, Chelsea and Westminster HospitalLondonUK
  4. 4.LondonUK

Personalised recommendations