J Korean Orthop Assoc.  2009 Jun;44(3):369-376. 10.4055/jkoa.2009.44.3.369.

Assessment of the Clinical Features of Bilateral Sequential Hip Fractures in the Elderly

• Kho DH
• Shin JY
• Kim HJ
• Kim DH

• KMID: 2186346
• DOI: http://doi.org/10.4055/jkoa.2009.44.3.369

Abstract

PURPOSE: We wanted to evaluate the clinical features after treating of bilateral sequential hip fractures in the elderly.
MATERIALS AND METHODS
We reviewed the clinical records of 21 patients who were older than 75 years and who underwent bilateral bipolar hemiarthroplasty for sequential hip fractures between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability, the activities of daily living, the mechanism of fracture and the associated medical conditions and arthritis.
RESULTS
Walking ability was recovered by 18 cases of primary fracture and by 14 cases of sequential fracture. Return to the activities of daily living was achieved by 14 cases of primary fracture and by 14 cases of sequential fracture. The fracture mechanism was a fall/slip in 20 cases and a fall from a height in 1 case. The associated arthritis was in the spine in 14 cases, the knee in 11 cases, the shoulder in 8 cases and Hallux valgus in 5 cases, and the associated medical conditions were mainly urge incontinence in 17 cases and cardiovascular disease in 16 cases. The other previous fractures were spine compression fracture in 11 cases, ankle fracture in 6 cases, distal radius fracture in 5 cases and pelvic ramus fracture in 2 cases.
CONCLUSION
Preventing recurrent falls plays a role in preventing bilateral sequential hip fractures. We think that the treatment of curable associated medical conditions and arthritis is necessary to prevent recurrent falls.

Keyword

Bilateral; Sequential; Hip fractures; Elderly

MeSH Terms

Activities of Daily Living
Aged
Animals
Ankle
Arthritis
Cardiovascular Diseases
Follow-Up Studies
Fractures, Compression
Hallux Valgus
Hemiarthroplasty
Hip
Hip Fractures
Humans
Knee
Radius Fractures
Shoulder
Spine
Urinary Incontinence, Urge
Walking

Figure

• 

  Fig. 1 (A) Radiograph shows left femur intertrochanteric fracture in 84 years old woman. (B) Postoperative radiograph shows bipolar hemiarthroplasty using a calcar replacement stem. (C) Radiograph 25 months later shows right femur intertrochanteric fracture. (D) Twenty-two months follow up radiograph shows bipolar hemiarthroplasty using a calcar replacement stem on both side.

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