Subsequent Hip Fracture in Osteoporotic Hip Fracture Patients

Kim, Hyung Surk; Lee, Sang Ho; Moon, Kyoung Ho

Abstract

OBJECTIVES
A significant number of patients who had a previous surgical treatment in the hip area experience subsequent hip fracture (SHF) on the opposite side. This study aims to analyze the risk factors and the correlation between osteoporosis and SHF on the opposite side by measuring bone mineral density (BMD) and treatment provided by risedronate for the prevention of SHF. MATERIAL & METHODS: We studied 475 patients without treatment who had unilateral hip and included following: death, SHF, alcoholism, living alone, dementia, dizziness, health status, osteoporotic treatment after fracture and BMD from March 1997 to June 2006. We selected 26 patients with SHF and the other 26 patients without SHF who had similar age, sex, BMI, BMD, diagnosis, treatment and follow up. The average follow up was 6.4 years (4~12 years) and 6.2 years (4~12 years).
RESULTS
The mortality rate was 138 (28.0%). There was no significant difference in the criteria listed earlier. The average T-score with SHF was -5.13 (-3.2~-6.6, S.D. 0.34) and -5.02 (-3.2~-6.8) without SHF. The BMD at time of fracture has no statistical difference between two groups (P>0.05). 7 patients (26.9%) were prescribed risedronate with SHF and 14 patients (53.8%) received the same treatment without SHF. There was a statistical relation whether they were treated for osteoporosis (P=0.048). The average BMD with SHF was -5.13 and without SHF was -5.02 (P>0.05).
CONCLUSION
Although primary surgical treatments are important for excellent outcome, osteoporotic treatment is as important to prevent SHF in prior hip fracture.