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Open Access Highly Accessed Research article

Hip fracture types in men and women change differently with age

David A Tanner, Marita Kloseck1, Richard G Crilly2*, Bert Chesworth1 and Jason Gilliland3

  • * Corresponding author: Richard G Crilly rcrilly@uwo.ca

  • † Equal contributors

Author Affiliations

1 Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada

2 Division of Geriatric Medicine, Parkwood Hospital, 801 Commissioners Road East, London, Ontario, N6C 5J1, Canada

3 Department of Geography, University of Western Ontario, London, Ontario, Canada

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BMC Geriatrics 2010, 10:12  doi:10.1186/1471-2318-10-12

Published: 9 March 2010

Abstract

Background

Hip fractures are expensive and a frequent cause of morbidity and mortality in the elderly. In most studies hip fractures have been viewed as a unitary fracture but recently the two main types of fracture (intertrochanteric and subcapital) have been viewed as two fractures with a different etiology and requiring a different approach to prevention. The relative proportion of intertrochanteric fractures increases with age in women. In previous studies no particular pattern in men has been noted. In this study, we explored changes in the relative proportion of the two fracture types with age in the two genders.

Methods

Patients of 50 years and older, with a diagnosis of hip fracture, discharged from two local acute care hospitals over a 5 year period (n = 2150) were analyzed as a function of age and gender to explore the relative proportions of intertrochanteric and subcapital fractures, and the change in relative proportion in the two genders with age.

Results

Overall, for the genders combined, the proportion of intertrochanteric fractures increases with age (p = .007). In women this increase is significant (p < .001), but in men the opposite pattern is observed, with the proportion of intertrochanteric fractures falling significantly with age (p = .025).

Conclusions

The pattern of hip fractures is different in men and women with aging. It is likely that the pattern difference reflects differences in type and rate of bone loss in the genders, but it is conjectured that the changing rate and pattern of falling with increasing age may also be important. The two main hip fracture types should be considered distinct and different and be studied separately in studies of cause and prevention.