Osteoporosis International

, Volume 28, Issue 6, pp 1989–1993 | Cite as

The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies

  • N. Maharlouei
  • S. Atefi
  • H. Namazi
  • S. Kazemifar
  • M. Soveid
  • H. R. Shahraki
  • Z. Farahmand
  • M. Khodayari
  • P. Arab
  • F. Forouzan
  • N. Allamehzadeh
  • S. Fazilat
  • S. Khademolhosseini
  • F. Nafari
  • K. B. LankaraniEmail author
Original Article



We evaluate the incidence of hip fracture in 50 years old or above in southwest of Iran. Age-adjusted incidence rates of hip fracture, standardized to the 2000 US white population, were 79.55 per 105 in total and 66.51 and 92.37 per 105 in male and female, respectively.


Osteoporosis-related hip fracture is associated with considerable morbidity, mortality, and costs in older people. The aim of this study was to evaluate the incidence rate of hip fracture in the capital of Fars Province, southern Iran.


This study was conducted in Shiraz, Iran, from September 1, 2011, to August 30, 2012. All 50-year-old or above patients with hip fracture diagnosis, lived in Shiraz at least 6 months prior to hospital admission, were included in this study. All statistical analyses were performed using SPSS, version 18.0, and Microsoft Excel 2007 software.


The mean age of 608 patients was 75.95 ± 11.07 and 353 (58.3%) were female. Age-adjusted incidence rates of hip fracture, standardized to the 2000 US white population, were 79.55 per 105 in total and 66.51 and 92.37 per 105 in male and female, respectively. The adjusted incidence rate of neck of the femur fracture (30.62 per 105 versus 23.49 per 105, p = 0.61) and intertrochanteric fracture (40.48 per 105 versus 28.5 per 105, p = 0.74) were higher in females than males but the differences were not statistically significant. Under the age of 65 years, the incidence rate of hip fracture was significantly higher in men, but after 65 years, it was higher among women.


The rate of osteoporotic hip fracture was relatively low in southern Iran. However, by aging population, this rate will increase and health policy makers should implement targeted osteoporosis screening and management programs.


Femoral neck fracture Fractures-spontaneous Hip fracture Incidence Iran 



The authors would like to appreciate the Vice-chancellor for Research affiliated to the International Branch of Shiraz University of Medical Sciences for the financial support. This manuscript is extracted from a thesis encoded 86.1027.

Compliance with ethical standards

Conflicts of interest



  1. 1.
    Tsukutani Y, Hagino H, Ito Y, Nagashima H (2015) Epidemiology of fragility fractures in Sakaiminato, Japan: incidence, secular trends, and prognosis. Osteoporos Int 26(9):2249–2255CrossRefPubMedGoogle Scholar
  2. 2.
    Lyritis GP, Rizou S, Galanos A, Makras P (2013) Incidence of hip fractures in Greece during a 30-year period: 1977-2007. Osteoporos Int 24(5):1579–1585CrossRefPubMedGoogle Scholar
  3. 3.
    Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23(9):2239–2256CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Azagra R, López-Expósito F, Martin-Sánchez JC, Aguyé A, Moreno N, Cooper C et al (2014) Changing trends in the epidemiology of hip fracture in Spain. Osteoporos Int 25(4):1267–1274CrossRefPubMedGoogle Scholar
  5. 5.
    Siggeirsdottir K, Aspelund T, Jonsson BY, Mogensen B, Gudmundsson EF, Gudnason V et al (2014) Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989-2008. Osteoporos Int 25(1):211–219CrossRefPubMedGoogle Scholar
  6. 6.
    El Maghraoui A, Ngbanda AR, Bensaoud N, Bensaoud M, Rezqi A, Tazi MA (2013) Age-adjusted incidence rates of hip fractures between 2006 and 2009 in Rabat, Morocco. Osteoporos Int 24(4):1267–1273CrossRefPubMedGoogle Scholar
  7. 7.
    Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H et al (2012) Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 23(3):949–955CrossRefPubMedGoogle Scholar
  8. 8.
    Adams AL, Shi J, Takayanagi M, Dell RM, Funahashi TT, Jacobsen SJ (2013) Ten-year hip fracture incidence rate trends in a large California population, 1997-2006. Osteoporos Int 24(1):373–376CrossRefPubMedGoogle Scholar
  9. 9.
    Prior JC, Langsetmo L, Lentle BC, Berger C, Goltzman D, Kovacs CS et al (2015) Ten-year incident osteoporosis-related fractures in the population-based Canadian multicentre osteoporosis study—comparing site and age-specific risks in women and men. Bone 71:237–243CrossRefPubMedGoogle Scholar
  10. 10.
    Cassell E, Clapperton A (2013) A decreasing trend in fall-related hip fracture incidence in Victoria, Australia. Osteoporos Int 24(1):99–109CrossRefPubMedGoogle Scholar
  11. 11.
    Briot K, Maravic M, Roux C (2015) Changes in number and incidence of hip fractures over 12 years in France. Bone 81:131–137CrossRefPubMedGoogle Scholar
  12. 12.
    Dhanwal DK, Dennison EM, Harvey NC, Cooper C (2011) Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop 45(1):15–22CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB (2014) The incidence rate of hip fracture in Shiraz, Iran during 2008-2010. Arch Osteoporos 9:165CrossRefPubMedGoogle Scholar
  14. 14.
    Soveid M, Serati AR, Masoompoor M (2005) Incidence of hip fracture in Shiraz, Iran. Osteoporos Int 16(11):1412–1416CrossRefPubMedGoogle Scholar
  15. 15.
    Tan WL, Low SL, Shen L, Das De S (2015) Osteoporotic hip fractures: 10-year review in a Singaporean hospital. J Orthop Surg (Hong Kong) 23(2):150–154CrossRefGoogle Scholar
  16. 16.
    Grigorie D, Sucaliuc A, Johansson H, Kanis JA, McCloskey E (2013) Incidence of hip fracture in Romania and the development of a Romanian FRAX model. Calcif Tissue Int 92(5):429–436CrossRefPubMedGoogle Scholar
  17. 17.
    Zerbini CA, Szejnfeld VL, Abergaria BH, McCloskey EV, Johansson H, Kanis JA (2015) Incidence of hip fracture in Brazil and the development of a FRAX model. Arch Osteoporos 10:224CrossRefPubMedGoogle Scholar
  18. 18.
    Gangavati A, Hajjar I, Quach L, Jones RN, Kiely DK, Gagnon P et al (2011) Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc 59(3):383–389CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Pérez-Castrillón JL, Martín-Escudero JC, Alvarez Manzanares P, Cortés Sancho R, Iglesias Zamora S, García Alonso M (2005) Hypertension as a risk factor for hip fracture. Am J Hypertens 18(1):146–147CrossRefPubMedGoogle Scholar
  20. 20.
    Sennerby U, Melhus H, Gedeborg R, Byberg L, Garmo H, Ahlbom A et al (2009) Cardiovascular diseases and risk of hip fracture. JAMA 302(15):1666–1673CrossRefPubMedGoogle Scholar
  21. 21.
    Ruths S, Bakken MS, Ranhoff AH, Hunskaar S, Engesæter LB, Engeland A (2015) Risk of hip fracture among older people using antihypertensive drugs: a nationwide cohort study. BMC Geriatr 15:153CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRefPubMedGoogle Scholar
  23. 23.
    Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  • N. Maharlouei
    • 1
  • S. Atefi
    • 2
  • H. Namazi
    • 3
  • S. Kazemifar
    • 1
  • M. Soveid
    • 1
  • H. R. Shahraki
    • 4
  • Z. Farahmand
    • 1
  • M. Khodayari
    • 5
  • P. Arab
    • 1
  • F. Forouzan
    • 6
  • N. Allamehzadeh
    • 7
  • S. Fazilat
    • 7
  • S. Khademolhosseini
    • 7
  • F. Nafari
    • 7
  • K. B. Lankarani
    • 1
    Email author
  1. 1.Health Policy Research CenterShiraz University of Medical SciencesShirazIran
  2. 2.Student Research CommitteeShiraz University of Medical Sciences, International BranchShirazIran
  3. 3.Department of Orthopedic SurgeryShiraz University of Medical SciencesShirazIran
  4. 4.Department of Biostatistics, School of MedicineShiraz University of Medical SciencesShirazIran
  5. 5.Goethe Universität Frankfurt am MainFrankfurt am MainGermany
  6. 6.Isfahan University of Medical SciencesIsfahanIran
  7. 7.Shiraz University of Medical SciencesShirazIran

Personalised recommendations