ArticleArchives of orthopaedic and trauma surgery2023
Predisposing factors for a second fragile hip fracture in a population of 1130 patients with hip fractures, treated at Oulu University Hospital in 2013-2016: a retrospective study.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Preoperative neutrophil-to-lymphocyte ratio and refracture risk in hip fracture patients: a propensity score-matched analysis.Annals of medicine · 2026Article
- Article
- Total radius BMD correlates with the hip and lumbar spine BMD among post-menopausal patients with fragility wrist fracture in a machine learning model.Archives of osteoporosis · 2025Article
- Hip structural analysis parameters are not associated with the risk of postmenopausal female second hip fracture: a retrospective study.BMC musculoskeletal disorders · 2025Observational
- The Second Hip Fracture is not an Independent Predictor of Poor Outcomes in Elderly Patients - A Case-Control Study.Geriatric orthopaedic surgery & rehabilitation · 2024Article
- Impact of Stroke History on the Risk of Recurrent Hip Fracture or Major Osteoporotic Fractures among Patients with Incident Hip Fracture: A Nationwide Cohort Study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2023Article
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4 authors at 2 institutions in 1 country.
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Abstract
objectiveThe life-time risk of a second fragile hip fracture is 8.4%, but the risk factors that predispose to a second hip fracture remain unresolved. This study aimed to define risk factors that predisposed patients to a second hip fracture.
methodsFor this retrospective study, we retrieved clinical data on 1130 patients with fragile hip fractures (67.2% female, mean age: 79.3 years) that underwent surgery at the Oulu University Hospital in 2013-2016. These data included the fracture risk assessment score (measured with the FRAX tool), the bone-mass T-score, laboratory values, ambulatory capacity, and the time of death.
resultsIn this population, 12.4% of patients sustained a second hip fracture. The predisposing factors for a second hip fracture were: female (p = 0.016), a high FRAX score (p = 0.020), and low physical capacity (p < 0.001). The vitamin D level recommended for treating osteoporosis (i.e., vitamin D > 75 nmol/l) was observed in only 24% of patients, and 42% of patients had ionized calcium levels below the reference range. According to the level of the cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), 37% of patients did not have high bone turnover. We found a positive correlation between age and ICTP (p = 0.001). The risk of death was higher after the second hip fracture (p = 0.005), but we found no difference in age between patients with first and second hip fractures (p = 0.11).
conclusionAfter a hip fracture, a second hip fracture is a well-known risk. Nevertheless, we found that only one-third of patients with a second hip fracture had used anti-osteoporosis medication at any time previously. These findings suggested that second hip fractures were most likely to occur in patients with osteopenic T-score values, in women more often than men, and in patients with high FRAX scores and low ambulatory capacity.
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