Risk Factors for Osteoporosis Are Common in Young and Middle-aged Patients with Femoral Neck Fractures Regardless of Trauma Mechanism

Overview

Journal Acta Orthop

Specialty Orthopedics

Date 2013 Jan 25

PMID 23343373

Citations 27

Authors

Amer N Al-Ani

Gustaf Neander

Bodil Samuelsson

Richard Blomfeldt

Wilhelmina Ekstrom

Margareta Hedstrom

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: There have been few prospective studies examining young and middle-aged patients with hip fracture. We therefore investigated background data, risk factors, and the trauma mechanism in young and middle-aged patients with femoral neck fracture.

Patients And Methods: 185 patients, 27 young (20-49 years old) and 158 middle-aged (50-69 years old) were prospectively included in a multicenter study lasting 3 years. Background data and risk factors for osteoporosis and fracture were obtained, and the type of injury was classified as low-energy trauma, high-energy trauma, or sports injury.

Results: In the young age group, the fracture occurred because of low-energy trauma in two-fifths of patients and because of sport injury in two-fifths of patients. The rest occurred because of high-energy trauma. The corresponding proportions for the middle-aged group were four-fifths, one tenth, and one tenth (p < 0.001). There was a higher proportion of men (19/27) in the young group than in the middle-aged group (69/158) (p = 0.001). One fifth of the young patients were smokers as compared to two-fifths in the middle-age group (p = 0.04). One quarter of the patients reported high-volume alcohol drinking, with no difference between the two groups. Furthermore, three-quarters of the young patients and four-fifths of the middle-aged patients had one or more risk factors for osteoporosis and fracture.

Interpretation: A minority of patients in each age group had high-energy trauma as the cause of their femoral neck fracture. Lifestyle factors and other non-trauma-related risk factors appear to have been important contributors to the occurrence of femoral neck fracture in both age groups.

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References

Kanis J, Burlet N, Cooper C, Delmas P, Reginster J, Borgstrom F . European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008; 19(4):399-428. PMC: 2613968. DOI: 10.1007/s00198-008-0560-z. View

Kanis J, Johansson H, Johnell O, Oden A, De Laet C, Eisman J . Alcohol intake as a risk factor for fracture. Osteoporos Int. 2004; 16(7):737-42. DOI: 10.1007/s00198-004-1734-y. View

Katz S, Ford A, Moskowitz R, Jackson B, JAFFE M . STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963; 185:914-9. DOI: 10.1001/jama.1963.03060120024016. View

Lofthus C, Osnes E, Meyer H, Kristiansen I, Nordsletten L, Falch J . Young patients with hip fracture: a population-based study of bone mass and risk factors for osteoporosis. Osteoporos Int. 2006; 17(11):1666-72. DOI: 10.1007/s00198-006-0176-0. View

Rogmark C, Johnell O . Primary arthroplasty is better than internal fixation of displaced femoral neck fractures: a meta-analysis of 14 randomized studies with 2,289 patients. Acta Orthop. 2006; 77(3):359-67. DOI: 10.1080/17453670610046262. View

Dolan P, Gudex C, Kind P, Williams A . The time trade-off method: results from a general population study. Health Econ. 1996; 5(2):141-54. DOI: 10.1002/(SICI)1099-1050(199603)5:2<141::AID-HEC189>3.0.CO;2-N. View

Askin S, Bryan R . Femoral neck fractures in young adults. Clin Orthop Relat Res. 1976; (114):259-64. View

Zetterberg C, Irstam L, Andersson G . Femoral neck fractures in young adults. Acta Orthop Scand. 1982; 53(3):427-35. DOI: 10.3109/17453678208992237. View

Tidermark J, Zethraeus N, Svensson O, Tornkvist H, Ponzer S . Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Qual Life Res. 2002; 11(5):473-81. DOI: 10.1023/a:1015632114068. View

10.

Swiontkowski M, Winquist R, Hansen Jr S . Fractures of the femoral neck in patients between the ages of twelve and forty-nine years. J Bone Joint Surg Am. 1984; 66(6):837-46. DOI: 10.2106/00004623-198466060-00003. View

11.

Jonsson B, Sernbo I, Kristensson H, Johnell O . Hip fractures in middle-aged men: a consequence of early retirement and alcohol misuse?. Alcohol Alcohol. 1993; 28(6):709-14. View

12.

Robinson C, Court-Brown C, McQueen M, Christie J . Hip fractures in adults younger than 50 years of age. Epidemiology and results. Clin Orthop Relat Res. 1995; (312):238-46. View

13.

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

14.

Thorngren K, Norrman P, Hommel A, Cedervall M, Thorngren J, Wingstrand H . Influence of age, sex, fracture type and pre-fracture living on rehabilitation pattern after hip fracture in the elderly. Disabil Rehabil. 2005; 27(18-19):1091-7. DOI: 10.1080/09638280500056402. View

15.

Pfeiffer E . A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975; 23(10):433-41. DOI: 10.1111/j.1532-5415.1975.tb00927.x. View

16.

Cheng K, Montgomery S, Housley S, Wheelwright E . Clinical Risk Factors for Hip Fracture in Young Adults Under 50 Years Old. Eur J Trauma Emerg Surg. 2016; 35(1):40-2. DOI: 10.1007/s00068-008-7177-y. View

17.

Kanis J, Johnell O, Oden A, Johansson H, De Laet C, Eisman J . Smoking and fracture risk: a meta-analysis. Osteoporos Int. 2004; 16(2):155-62. DOI: 10.1007/s00198-004-1640-3. View

18.

Nguyen N, Pongchaiyakul C, Center J, Eisman J, Nguyen T . Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res. 2005; 20(11):1921-8. DOI: 10.1359/JBMR.050520. View

19.

Kanis J . Osteoporosis: a view into the next century. Neth J Med. 1997; 50(5):198-203. DOI: 10.1016/s0300-2977(97)00014-4. View

20.

Holmberg A, Johnell O, Nilsson P, Nilsson J, Berglund G, Akesson K . Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women. Osteoporos Int. 2005; 16(12):2185-94. DOI: 10.1007/s00198-005-2006-1. View