Incidence of subsequent hip fractures is significantly increased within the first month after distal radius fracture in patients older than 60 years

J Trauma Acute Care Surg. 2013 Jan;74(1):317-21. doi: 10.1097/ta.0b013e31824bb325.

Abstract

Background: Distal radius fracture is recognized as an osteoporosis-related fracture in aged population. If another osteoporosis-related fracture occurs in a short period, it represents a prolonged hospitalization and a considerable economic burden to the society.We evaluated the relationship between distal radius fracture and subsequent hip fracture within 1 year, especially in the critical time and age.

Methods: We identified newly diagnosed distal radius fracture patients in 2000 to 2006 as an exposed cohort (N = 9,986). A comparison cohort (N = 81,227) was randomly selected from patients without distal radius fracture in the same year of exposed cohort. The subjects were followed up for 1 year since the recruited date.We compared the sociodemographic factors between two cohorts.Furthermore, the time interval following the previous distal radial fracture and the incidence of subsequent hip fracture was studied in detail.

Results: The incidence of hip fracture within 1 year increased with age in both cohorts. The risk was 5.67 times (84.6 vs. 14.9 per 10,000 person-years) greater in the distal radial fracture cohort than in the comparison cohort. The multivariate Cox proportional hazard regression analyses showed the hazard ratios of hip fracture in relation to distal radial fracture was 3.45 (95% confidence interval = 2.59-4.61). The highest incidence was within the first month after distal radial fracture, 17-fold higher than the comparison cohort (17.9 vs. 1.05 per 10,000). Among comorbidities, age 9 60 years was also a significant factor associated with hip fracture (hazard ratio = 8.67, 95% confidence interval = 4.51-16.7).

Conclusions: Patients with distal radius fracture and age 960 years will significantly increase the incidence of subsequent hip fracture, especially within the first month.

Level of evidence: Prognostic/epidemiologic study, level II.

MeSH terms

  • Adult
  • Female
  • Hip Fractures / complications*
  • Hip Fractures / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Osteoporotic Fractures*
  • Proportional Hazards Models
  • Radius Fractures / complications*
  • Risk Factors