title: Outcome following a second hip fracture.
abstract: Hip fracture has a significant impact on medical resources and patient morbidity and mortality. Few patients admitted with a hip fracture are considered for prophylactic measures aimed at the reduction of further fracture risk. Currently, 10-13% of patients will later sustain a second hip fracture. In considering the possible role of prophylactic measures in the prevention of second hip fracture, we investigated whether second hip fracture has a significant further impact on patients' mobility and social independence. We also sought to identify a pattern to second hip fracture that may allow targeting of those patients who are most likely to benefit from currently available prophylactic measures. We undertook a retrospective review of 49 consecutive patients admitted with a second hip fracture between August 1999 and September 2000. Fewer patients maintained their ability to walk independently after the second fracture than did so after the first (53 and 91% respectively, P<0.0005). Following second hip fracture, patients' level of mobility determined their future social independence. Older patients and those with a history of multiple falls had a shorter time interval between fractures. Second hip fracture has a significant further impact on patients' mobility and social independence. Younger patients and those without a history of multiple falls are most likely to benefit from medical prophylaxis.
authors.affiliation: Worthing Hospital, Worthing and Southlands NHS Trust, Lyndhurst Road, Worthing, West Sussex, UK. yemipearse@aol.com
authors.forename: E O
authors.initials: EO
authors.lastname: Pearse
authors.forename: D J
authors.initials: DJ
authors.lastname: Redfern
authors.forename: M
authors.initials: M
authors.lastname: Sinha
authors.forename: A J
authors.initials: AJ
authors.lastname: Edge
mesh_terms: D000368:Aged; D015519:Bone Density; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology / Q000517:prevention & control* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D004164:Diphosphonates