Subsequent hip fracture in osteoporotic hip fracture patients.

초록

Purpose : A significant number of patients who have experienced previous surgical treatment for an osteoporotic hip fracture, experienced a 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 in order to assess the usefulness of bisphosphonate treatment for the prevention of SHF. Material and methods : We included 517 patients in this study. Inclusion criteria included a previous unilateral hip fracture, without osteoporotic treatment and with a T-score less than -3.0 at the time of fracture from March 1997 to April 2009. We studied these patients in terms of death, SHF, alcoholism, living alone, dementia, dizziness, health status, osteoporotic treatment after fracture and BMD. 34 patients experienced a SHF. We selected another 34 patients without a SHF who had similar age, sex, BMI, BMD, diagnosis, treatment and a follow up period for a matched pair study. We compared these two groups. The average follow up was 8.3 years and 8.1 years, respectively. Results : The mortality rate of the 517 patients was 138 (27%). The BMD at the time of fracture demonstrates no statistical difference between the two groups (p>0.05). Nine patients (26%) were prescribed Risedronate within the SHF group and 18 patients (53%) received the same treatment in the non-SHF group. There was a statistical relationship to the treatment of osteoporosis (p=0.026). 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 an excellent outcome in osteoporotic hip fractures, treatment of osteoporosis itself is just as important to prevent SHF. Key words : Hip fracture, Osteoporosis, Bone mineral density, Subsequent fracture