Incidence Of Trochanteric Fractures Research Articles

RELATION OF FEMUR FRACTURES LOCATION WITH CLINICAL OUTCOMES IN ELDERLY PATIENTS.

This study was designed to investigate the possible relationship between the anatomical location of the PFF (head-neck fractures) and the demographic features, comorbidities, and risk factors of elderly patients. 233 patients aged 65 years and over, who were admitted to the emergency department with a diagnosis of proximal femur fracture were included in this study. Most patients (59.6%) had a trochanteric fracture. The incidence of trochanteric fractures had a statistically significant positive correlation with age. Falls at ground level were found to be highly associated with trochanteric fractures (92,8%). At least one complication was observed in 57 (41,0%) cases and 31 (22,3%) died in one year, of the patients with trochanteric fractures. Comorbidity was not related to fracture location statistically. Fall ground level (p = 0.013), complication rate (73.7%; p <0.001), and Charlesen comorbidity index (p = 0.019) were statistically significantly associated with death. The logistic regression analysis of variables determined that only the quantity of comorbidities may be related to femoral neck fractures (p = 0.047). Female patients with trochanteric fractures were found to be older than male patients. Fall ground level, mortality, and complications were more frequently seen in patients with trochanteric fractures. Level of Evidence II, Retrospective study.

Decennial trends in hip fractures over 20 years in Yamagata Prefecture, Japan

BackgroundHip fracture is among the most common injuries in elderly people. We aimed to investigate the decennial trends in hip fractures in patients ≥65 years of age. MethodsA questionnaire was distributed to all hospitals with a Department of Orthopaedic Surgery in Yamagata Prefecture to collect data on hip fractures occurring in 1996, 2006 and 2016. ResultsThe response rate was 100%. The total numbers of hip fractures in 1996, 2006 and 2016 were 665, 1169 and 1,728, respectively (crude incidence: 258, 373 and 494 per 100,000 person-year, respectively). Injuries frequently occurred in the early morning and daytime morning in 1996. In contrast, they frequently occurred in activity times (e.g., morning and afternoon) in 2006 and 2016. Among the patients, 80–90% were injured by simple falls, and 70–80% were injured indoors. The incidence of trochanteric fractures was approximately 1.8–1.9 times greater than incidence of neck fractures in all years. Especially, trochanteric fractures in females of ≥90 years of age markedly increased. The rate of surgical treatment was the same in 1996 and 2006, but was lower in 2016. In 1996, the percentage of independent walkers at discharge and 1 year later was almost the same. In 2006 and 2016, the rate of independent walkers was low at discharge, but increased 1 year later. The rate of discharge to home decreased gradually. The combined percentage of patients discharged to home and to rehabilitation institutions in 2006 and the percentage of patients who entered the regional referral clinical pathway in 2016 were both approximately 70%, with no marked changes observed. ConclusionsHip fractures, especially trochanteric fractures in super-aged females, increased. Discharge to home decreased, and the use of the regional referral clinical pathway was widespread. Ambulation ability was reduced at discharge, but improved after 1 year.

Clinical profile of patients with intertrochanteric fracture of femur

The incidence of trochanteric fractures is more in the female population due to osteoporosis compared to male. In a Swedish study of more than 20,000 patients, the incidence of hip fractures in women doubled every 5.6 years after the age of 30 years. The trochanteric fractures can be managed by conservative methods and there is usually union of the fracture. If suitable precautions are not taken, it undergoes malunion, leading to varus and external rotation deformity and shortening and restriction of hip movements. After the patient with stable and unstable intertrochanteric fracture was admitted to hospital all the necessary clinical details were recorded in proforma prepared for this study. After the completion of the hospital treatment patients were discharged and called for follow up at outpatient level at regular intervals for serial clinical and radiological evaluation. In our study, intertrochanteric fractures were more common due to Slip and fall. Age ranged from 46 to 73 years with mean age of 60.75 years. Males were more common contributing of 85 % of cases. Right sided fractures were more common in our study accounting for 60% of cases. In our study Trochanteric fractures of 20 cases, out of which boyd and griffin type 2 consisted of 45% followed by 30% were type 3.

Klinische Evaluation des PFNA® und Zusammenhang zwischen Tip-Apex-Distanz und mechanischem Versagen

The incidence of trochanteric fractures is increasing in Europe, and the economic impact and mortality is high. The aim of the study was to evaluate the PFNA® (proximal femoral nail antirotation) with respect to its clinical use and mechanical complications.All patients with a trochanteric fracture who had been treated with a PFNA® between 12/2004 and 12/2007 were identified and analysed regarding complications and radiological findings. The study included 195 patients; 61.2% of the patients were classified as Singh I und II. The mean duration of surgery was 57min. In ten cases (5.1%) the blade migrated, four cases (2.1%) showed blade cut out and in one case the nail broke (0.5%). The mean TAD was 26.7 mm, in cases of cut out 41.3 mm and in blade migrations 38.6 mm. No failure could be documented when the TAD was less then 30 mm. There is a strong relationship between increasing TAD and mechanical failure (P<0.001); 84.6% of the patients have been followed up, and 30.2% died in the follow-up period.The PFNA® is an easy-to-use implant for the treatment of stable and instable proximal femur fractures. Mechanical failure depends on the TAD.

A nationwide seven-year trend of hip fractures in the elderly population of Taiwan

To investigate the recent longitudinal trend of hip fractures (including cervical and trochanteric fractures) in Taiwan's elderly population (≥ 65 years), a nationwide descriptive epidemiological study was conducted using the database of the Bureau of National Health Insurance from 1996 through 2002. Frequencies and incidences of hip fracture by gender, fracture site, and age group were estimated, and the 7-year incidence trend was further evaluated. The results showed that a total of 75,482 hip fractures occurred during the study period with an incidence rate of 57.54 per 10,000 per year. Overall incidence significantly increased by 30% ( p < 0.0001), from 49.56 to 64.37 per 10,000 per year during the 7-year study period. The increase in rates was greater in males (36%) than in females (22%). The average female-to-male ratio was 1.76, lower than those in many countries. In females, the annual incidence of cervical fracture was higher than that of trochanteric fractures throughout the 7 years, while the incidence of trochanteric fractures was higher than cervical fractures each year in males ( p < 0.0001). The average annual incidence of patients older than 85 years was 9.9 times higher than that of aged 65 to 69 years in females and 7.9 times in males. Development and implementation of public health strategies for hip fractures should more focus on these subgroups in Taiwan's rapidly aging society.

Ostéosynthèse des fractures trochantériennes par vis-plaque D.H.S. Etude rétrospective de 223 patients

The incidence of trochanteric fractures is currently increasing. The introduction of new devices aims to secure the position of the reduction, and allow patients to mobilize early. Material and methods: 227 fractures in 223 patients were treated in our hospital with DHS between 1991 and 1993, and were followed up to fracture union. There were 87 men and 136 women; the average age was 77,4 years (21–101 years). Using Ender’s classification 68,58 % of these fractures were type 1 or type 2. Results: The average operative time was 48 min; open reduction was only required for 54 fractures. The mean rate of blood loss was 187 cc. Radiological examination showed anatomical reduction for 176 fractures, poor reduction (displacement between 5 and 10o) in 33 cases and varus displacement in 16 cases. One reoperation was rapidly required because of valgus displacement more than 20o. Quality of fixation was assessed by the screw position in the femoral head : 72% were correct. All patients walking before the fracture restarted walking with a frame on the second postoperative day and the average time of weight bearing was 18 days. Complications: Superficial sepsis (3 cases) or haematoma (17 cases) were not significant. 3 patients required further treatment : in one case, because of a refracture under the plate, in one other case, because of a displacement of the screw and in the last case because of a bad reduction. A pathologic fracture occured in one case. These cases were considered to be errors of surgical technique. Deep vein thrombosis occured in 5 patients. The death rate was 22% : 11 patients died within the first month after the fracture, 35 died between the first and third months. Follow-up: 177 surviving patients were reviewed 3 months after surgery. All fractures achieved union. The mean rate of healing was 2,6 months. Functional results were good : 31 patients walked independantly, 66 needed a cane, 42 two canes, 20 a frame. 77% of these patients walked without pain. 5 patients were not able to walk. Joint movements were reduced: hip flexion was more than 100o for 116 patients. Radiological examination showed anatomical union in 141 cases; 22 fractures healed with a valgus displacement and 7 with a varus displacement. Discussion: These results are analyzed and compared with several other published studies.

HIP FRACTURES IN MIDDLE-AGED MEN: A CONSEQUENCE OF EARLY RETIREMENT AND ALCOHOL MISUSE?

From the 1950s to the 1980s the incidence of hip fractures in women aged 50-64 and cervical fractures in men of the same age in Malmö did not increase, whereas the incidence of trochanteric fracture in men aged 50-64 increased significantly. Significant background factors in men were alcohol misuse, living alone, early retirement, previous fractures, low weight/height ratio and less severe trauma--more in men with trochanteric than in men with cervical fracture. The deviant life-style and suspected physical inertia in this group of middle-aged men probably predisposes to osteoporosis and increased fracture risk.

Changing incidence and residual lifetime risk of common osteoporosis-related fractures

Changes in incidence and lifetime risk of fractures are of major importance in the epidemiology of osteoporosis. We focused on hip fractures in women and men and on radial and humeral fractures in women. The study subjects comprised 4500 women and men 20 years old or more with fractures. In women 1735 fractures of the distal radius, 747 fractures of the proximal humerus, 878 cervical and 635 trochanteric hip fractures were included. In men 273 cervical and 232 trochanteric hip fractures were included. The fractures were registered during the period 1976 to 1984 and changes in age-specific incidence were calculated (chi-squared test for linear trend; p-values less than 0.05 were considered significant). On the basis of life tables and population background data, the lifetime risk was estimated. The incidence of cervical hip fractures in women aged 60-89 years decreased significantly (p < 0.05) during the observation period, while no significant decrease was found in the incidence of trochanteric fractures. No significant changes in incidence were observed in women with radial or humeral fractures, or in men with hip fractures. A women 60 years old with a life expectancy of 81 years had an estimated residual lifetime risk of radial, humeral or hip fracture of 17%, 8% and 14% respectively. A man 60 years of age with a life expectancy of 77 years had an estimated risk of hip fracture of 6%.(ABSTRACT TRUNCATED AT 250 WORDS)

The incidence of hip fracture in Uppsala County. Change of time trend in women.

The incidence of hip fracture in the population over 55 years in Uppsala County was calculated for the years 1980-1991. Specific incidences were calculated for each age, sex, and fracture type group. The time trend for the change in incidence was calculated for each group with linear regression using an exponential model. The overall incidence of hip fracture in both sexes over 55 years, standardized to the 1985 population, remained steady at 6/1000 during the study period. The incidence of cervical fractures in women showed a decrease in all age groups except over 85 years of age, where the incidence was constant. The corresponding incidence in men did not change over time. The incidence of trochanteric fracture increased in men 65-74 years of age and in women over 85 years of age. The incidence of trochanteric fracture in the rest of the age and sex groups remained unchanged.

Increased Hip-Fracture Incidence in the County of Östergötland, Sweden, 1940–1986, with Forecasts up to the Year 2000: An Epidemiological Study

The incidence of hip fractures in the county of Ostergötland in Sweden has increased dramatically from 1940 to 1986, mainly due to an increase in age-specific incidence of trochanteric fractures. The increase is most pronounced in people over 80 but is present even in age groups down to 50 years. If the age-specific incidence rates continue to increase, and the population of the elderly grows in accordance with the forecast, there will be 70% more hip fractures in the year 2000 than in 1985.

Hip fracture incidence in Stockholm 1972-1981.

We studied the incidence of cervical and trochanteric hip fractures in Stockholm, Sweden from 1972 through 1981. The material, selected from a computerized medical information register, consisted of 11 812 cervical fractures and 8094 trochanteric fractures. The incidence did not change in the age group 50-74 years. In males 75 years of age and older, the incidence of both fracture types caused by moderate trauma increased annually by 5-6 per cent. In females 75 years and older, the incidence of trochanteric fractures caused by moderate trauma increased annually by 6 per cent, whereas the incidence of cervical fractures increased only marginally.