Skip to main content
SpringerLink
Log in

Assessment of risk factors for second hip fractures in Japanese elderly

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

In an attempt to identify a cohort with a high risk of suffering a fracture of the contralateral hip (second hip fracture), we assessed patients who had suffered hip fracture. A total of 714 patients (130 men and 584 women) were prospectively followed to determine those who suffered a second hip fracture. Pathologic hip fractures and fractures that emerged from high-energy trauma were excluded from the analysis. Age, gender, Singh Index (SI), fracture type, cognitive impairment, and comorbid medical conditions were investigated as medical predictors. The 714 patients were observed for 1,579.5 person-years (mean: 2.4±1.4 years per patient). During the observation period, 45 second hip fractures were identified (bilateral group), giving an overall incidence of 0.029 per person-year. The annual incidence rate declined linearly from the occasion of the initial fracture. Furthermore, the second hip fracture tended to occur increasingly within 8 months after the initial hip fracture. The second hip fracture was of the same type (trochanteric or cervical) in 79% of the trochanteric and 71% of the cervical fractures. There was no significant difference in the incidence of second hip fracture by gender or age. In addition, there was no significant difference in the distribution of SI grades of the unfractured hip at the initial hip fracture between the 669 patients who had not suffered a second hip fracture (unilateral group) and the bilateral group. Cox proportional hazard regression analysis revealed that increased risk of a second hip fracture was associated with senile dementia and Parkinson’s disease. We concluded that careful follow-up of hip fracture patients associated with senile dementia and Parkinson’s disease might effectively prevent the incidence of a second hip fracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Magaziner J, Simonsick EM, Kashner TM et al (1989) Survival experience of aged hip fracture patients. Am J Public Health 79:274–278

    CAS  PubMed  Google Scholar 

  2. Roos LL, Fisher ES, Sharp SM et al (1990) Postsurgical mortality in Manitoba and New England. JAMA 263:2453–2458

    Google Scholar 

  3. Orimo H, Hashimoto T, Sakata K et al (2000) Trends in the incidence of hip fracture in Japan, 1987–1997: the third nationwide survey. J Bone Miner Metab 18:126–131

    Google Scholar 

  4. Cooper C, Atkinson EJ, Jacobsen SJ et al (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005

    CAS  PubMed  Google Scholar 

  5. Kitamura S, Hasegawa Y, Suzuki S et al (1998) Functional outcome after hip fracture in Japan. Clin Orthop 348:29–36

    Article  PubMed  Google Scholar 

  6. Boston DA (1982) Bilateral fractures of the femoral neck. Injury 14:207–210

    Google Scholar 

  7. Dretakis E, Kritsikis N, Economou K et al (1981) Bilateral non-contemporary fractures of the proximal femur. Acta Orthop Scand 52:227–229

    Google Scholar 

  8. Singh M, Nagrath AR, Maini PS (1970) Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am 52:457–467

    Google Scholar 

  9. Hoffer MM, Feiwell E, Perry R et al (1973) Functional ambulation in patients with myelomeningocele. J Bone Joint Surg Am 55:137–148

    Google Scholar 

  10. Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248–1250

    Google Scholar 

  11. Anderson GH, Raymakers R, Gregg PJ (1993) The incidence of proximal femoral fractures in an English county. J Bone Joint Surg Br 75:441–444

    Google Scholar 

  12. Schroder HM, Peterson KK, Erlandsen M (1993) Occurrence and incidence of the second hip fracture. Clin Orthop 289:166–169

    PubMed  Google Scholar 

  13. Finsen V, Benum P (1986) The second hip fracture. An epidemiological study. Acta Orthop Scand 57:431–433

    Google Scholar 

  14. Chiu KY, Pun WK, Luk KD et al (1992) Sequential fractures of both hips in elderly patients—a prospective study. J Trauma 32:584–587

    Google Scholar 

  15. Wolinsky FD, Fitzgerald JF (1994) Subsequent hip fracture among older adults. Am J Public Health 84:1316–1318

    Google Scholar 

  16. Chapurlet RD, Bauer DC, Nevitt M et al (2003) Incidence and risk factors for a second hip fracture in elderly women. The study of osteoporotic fractures. Osteoporos Int 14:130–136

    CAS  PubMed  Google Scholar 

  17. Mautalen CA, Vega EM, Einhorn TA (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone 18:133S–137S

    Article  CAS  PubMed  Google Scholar 

  18. Greenspan SL, Myers ER, Maitland LA et al (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9:1889–1894

    Google Scholar 

  19. Michaelsson K, Weiderpass E, Farahmand BY et al (1999) Differences in risk factor patterns between cervical and trochanteric hip fractures. Swedish Hip Fracture Study Group. Osteoporos Int 10:487–494

    Article  PubMed  Google Scholar 

  20. Hinton RY, Lennox DW, Ebert FR et al (1995) Relative rates of fracture of the hip in the United States. Geographic, sex, and age variation. J Bone Joint Surg Am 77:695–702

    CAS  PubMed  Google Scholar 

  21. Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. New Engl J Med 332:767–773

    Article  CAS  PubMed  Google Scholar 

  22. Cummings SR (1996) Treatable and untreatable risk factors for hip fracture. Bone 18:165S–167S

    Google Scholar 

  23. Dretakis KE, Dretakis EK, Papakitsou EF at al (1998) Possible predisposing factors for the second hip fracture. Calcif Tissue Int 62:366–369

    Google Scholar 

  24. Pogrund H, Rigal WM, Makin M et al (1981) Determination of osteoporosis in patients with fractured femoral neck using the Singh index. Clin Orthop 156:189–195

    Google Scholar 

  25. Heneghan JP, Kirke PN, Murphy BL et al (1997) Evaluation of quantitative CT vertebral bone mineral density measurement and the Singh index in elderly females with hip fractures—a case control study. Br J Radiol 70:923–928

    Google Scholar 

  26. Gluer CC, Cummings SR, Pressman A et al (1994) Prediction of hip fractures from pelvic radiographs: the study of osteoporotic fractures. J Bone Miner Res 9:671–677

    CAS  PubMed  Google Scholar 

  27. Grisso JA, Kelsey JL, Strom BL et al (1991) Risk factors for falls as a cause of hip fracture in women. New Engl J Med 324:1326–1331

    Google Scholar 

  28. Horiuchi T, Igarashi M, Karube S et al (1988) Spontaneous fractures of the hip in the elderly. Orthopedics 11:1277–1280

    Google Scholar 

  29. Yamanashi A, Kushida K, Yamanzaki K et al (1998) The bone mineral density and geometric factor in patients with spontaneous fracture of the hip. J Jpn Soc Bone Morphom 8:101–106

    Google Scholar 

  30. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. New Engl J Med 319:1701–1707

    Google Scholar 

  31. Nevitt MC, Cummings SR, Kidd S et al (1989) Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 261:2663–2668

    Article  CAS  PubMed  Google Scholar 

  32. Martin JP (1967) The basal ganglia and posture. Pitman Medical, London

  33. Buchner DM, Larson EB (1987) Falls and fractures in patients with Alzheimer-type dementia. JAMA 257:1492–1495

    Google Scholar 

  34. Oleske DM, Wilson RS, Bernard BA et al (1995) Epidemiology of injury in people with Alzheimer’s disease. J Am Geriatr Soc 43:741–746

    Google Scholar 

  35. Koval KJ, Skovron ML, Aharonoff GB et al (1995) Ambulatory ability after hip fracture: A prospective study in geriatric patients. Clin Orthop 310:150–159

    Google Scholar 

  36. Zuckerman JD (1996) Hip fracture. N Engl J Med 334:1519–1525

    Article  PubMed  Google Scholar 

  37. Stewart A, Walker LG, Porter RW et al (1999) Predicting a second hip fracture. J Clin Densitom 2:363–370

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan

    Akihiro Yamanashi, Kaoru Yamazaki, Kuniyoshi Mochizuki, Shozo Okamoto, Youichi Koide, Kokai Kin & Akira Nagano

  2. Department of Public Health and Sport Medicine, B213, Kitahira, Shiga-cho, 520-0503, Shiga-ken, Japan

    Masao Kanamori

Authors
  1. Akihiro Yamanashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaoru Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masao Kanamori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kuniyoshi Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shozo Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Youichi Koide
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kokai Kin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akira Nagano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akihiro Yamanashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamanashi, A., Yamazaki, K., Kanamori, M. et al. Assessment of risk factors for second hip fractures in Japanese elderly. Osteoporos Int 16, 1239–1246 (2005). https://doi.org/10.1007/s00198-005-1835-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-1835-2

Keywords

Search

Navigation