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Risk factors for second hip fracture in elderly patients: an age, sex, and fracture type matched case–control study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Prevention of second hip fracture is mandatory for orthopedic surgeons. We aimed to clarify the incidence and duration of second hip fracture, to compare survival rate and walking ability of patients with a second hip fracture to that of patients with a unilateral fracture, and to identify risk factors for second hip fracture using matched case–control methods.

Methods

This retrospective study conducted in a single tertiary emergency center comprised 119 patients with second hip fractures who underwent bilateral operations at our institution from 2007 to 2017 (second hip fracture group [Group A]). The control group (Group B) comprised 357 patients matched to Group A for age, sex, and fracture type.

Results

The incidence of second hip fracture was 7.6%, and the average interval from initial fracture to second hip fracture was 22.8 months. Significantly more patients in Group A had decreased postoperative walking ability. Five-year survival rates from initial fracture were 65.0% in Group A and 50.6% in Group B (P = 0.346). Dementia and heart disease were identified as independent risk factors (dementia: HR 2.08, 95% CI 1.27–3.41, P = 0.004; heart disease: HR 1.27, 95% CI1.11–3.22, P = 0.019). Valvular disease was also revealed to be a risk factor for heart disease (P = 0.0272).

Conclusions

The incidence of second hip fracture was not low. Although survival rates did not differ between the patients with or without second hip fracture, walking ability of patients with second hip fracture worsened. Dementia and cardiac disease could be risk factors for second hip fracture in elderly patients, and valvular disease might be associated with second hip fracture in patients with heart disease.

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Data availability

The datasets created during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Gifu Prefectural Tajimi Hospital, Gifu, Japan

    Tomoki Fujita, Yasuomi Sakai, Hiroatsu Nakashima & Shiro Takatsu

  2. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Tomoki Fujita, Yasuhiko Takegami, Kei Ando & Shiro Imagama

Authors
  1. Tomoki Fujita
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  2. Yasuhiko Takegami
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  3. Kei Ando
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  4. Yasuomi Sakai
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  5. Hiroatsu Nakashima
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  6. Shiro Takatsu
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  7. Shiro Imagama
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Contributions

YT and SI involved in conceptualization; YT and TF involved in methodology; TF and YT participated in formal analysis and investigation; TF participated in writing—original draft preparation; YT involved in writing—review and editing; YS, HN, TT participated in resources; SI supervised the study.

Corresponding author

Correspondence to Yasuhiko Takegami.

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Fujita, T., Takegami, Y., Ando, K. et al. Risk factors for second hip fracture in elderly patients: an age, sex, and fracture type matched case–control study. Eur J Orthop Surg Traumatol 32, 437–442 (2022). https://doi.org/10.1007/s00590-021-02996-0

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  • DOI: https://doi.org/10.1007/s00590-021-02996-0

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