Risk factors for osteoporosis are common in young and middle-aged patients with femoral neck fractures regardless of trauma mechanism

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.

AA: statistical analysis of data and writing of the manuscript. GN, RB, and WE: participated in study design and inclusion of patients. BS: participated in inclusion of patients and data collection. MH: participated in the original design of the study and in writing of the manuscript. All authors contributed to editing and revision of the manuscript. Members of the Stockholm Hip Fracture Group participated in study design, data collection, and preparation of the data file.

Financial support was provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, and by the Swedish Orthopedic Association, the King Gustaf V and Queen Victoria Freemason Foundation, and the Swedish Society of Medicine. The abstract was presented at the Swedish Orthopaedic Association meeting in Gothenburg on September 1, 2010. Thanks to the Stockholm Hip Fracture Group for running the study: Jan Tidermark, Nils Dalén, Sari Ponzer, Eva Samnegård, K-G Thorngren, Anita Söderqvist, Bodil Samuelsson, Åsa Norling, Kristina Källbom, and Paula Kelly-Pettersson.

No competing interest declared.