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Hip fractures in young adults: a retrospective cross-sectional study of characteristics, injury mechanism, risk factors, complications and follow-up

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Abstract

Summary

This study characterises risk factors, complications and follow-up of minimal trauma hip fractures in young adults, adding to limited information examining the management framework. This group have severe systemic disease and significant risk of post-operative complications and subsequent fractures. Improved medical referral pathways enable management of osteoporosis and comorbid diseases.

Aims

There is a paucity of literature examining minimal trauma hip fractures in young adults, despite extensive management guidelines for older patients. This study aims to characterise risk factors, complications and follow-up of hip fractures to guide management pathways.

Methods

This is a retrospective study of patients presenting with hip fracture to a single institution from 2009 to 2015. Hip fractures were identified using ICD-10 codes and clinical information documented from medical records. Patients were categorised into minimal trauma (MTF) and high-energy fracture (HEF) groups based on mechanism of injury.

Results

Of 2512 patients admitted with hip fracture, 2.5% (n = 62) were aged 15–49 years. Two patients were excluded with pathological fractures, and seven were excluded with no recorded mechanism of injury. MTF occurred in 43 patients and 10 sustained HEF. These groups had similar demographics, fracture locations and treatments. The MTF group had higher American Society of Anaesthesiologists scores (MTF 2.44 ± 0.9; HEF 1.43 ± 0.5; p = 0.025) and higher rates of chronic endocrine disease (MTF 34.9%; HEF 0%; p = 0.046). Rates of post-operative surgical (MTF 24.0%; HEF 12.5%) and medical complications (MTF 27.8%; HEF 12.5%) were high in MTF patients. Subsequent fractures occurred in five (13.9%) MTF patients during the study period compared with none in the HEF group. Only 16 (44.4%) of the MTF patients were referred to endocrine care.

Conclusion

Young adults with MTF of the hip have more severe systemic disease and are at risk of post-operative complications and subsequent fractures. Referral of patients to endocrine care is recommended to manage osteoporosis and comorbid diseases.

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Authors and Affiliations

  1. Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia

    Michael T. Wang & Sarah H. Yao

  2. Department of Endocrinology, Monash Health, Clayton, Australia

    Phillip Wong, Anne Trinh, Peter R. Ebeling & Frances Milat

  3. Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia

    Phillip Wong, Anne Trinh, Peter R. Ebeling & Frances Milat

  4. Hudson Institute for Medical Research, Clayton, Australia

    Phillip Wong, Anne Trinh & Frances Milat

  5. Department of Orthopaedic Surgery, Monash Health (Dandenong Hospital), Dandenong, Australia

    Ton Tran & Nora Mutalima

  6. Department of Surgery, Monash University, Clayton, Australia

    Nora Mutalima

Authors
  1. Michael T. Wang
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  2. Sarah H. Yao
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  3. Phillip Wong
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  4. Anne Trinh
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  5. Peter R. Ebeling
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  6. Ton Tran
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  7. Frances Milat
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  8. Nora Mutalima
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Corresponding author

Correspondence to Michael T. Wang.

Additional information

Michael T. Wang and Sarah H. Yao are equal first authors.

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Wang, M.T., Yao, S.H., Wong, P. et al. Hip fractures in young adults: a retrospective cross-sectional study of characteristics, injury mechanism, risk factors, complications and follow-up. Arch Osteoporos 12, 46 (2017). https://doi.org/10.1007/s11657-017-0339-y

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  • DOI: https://doi.org/10.1007/s11657-017-0339-y

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