Prefracture syndrome of the hip fracture: a case control study.
BACKGROUND
Hip fractures result from both bone fragility and trauma, more often a sideways fall. Spontaneous hip fractures have been described; in such cases, patients reported pain ("prefracture" syndrome) in the hip region for weeks before the fracture.


OBJECTIVE
To identify the proportion of patients who had a pain in the hip region before a hip fracture, to compare this proportion to the one observed in controls and to describe the characteristics of this pain.


METHODS
For a period of 6 months, each subject (>65 years) treated for hip fracture was prospectively recruited in an orthopaedic surgery department. Exclusion criteria were: alterations of cognitive functions (defined by a mini mental state <20), refusal, and fractures related to bone metastasis or multiple myeloma. Subjects were compared to sex-matched controls consulting in an acute care geriatrics unit. They were asked about the occurrence of pain in hip region before the fracture and its characteristics.


RESULTS
Thirty-eight patients (31 women, 7 men, mean age 83.1 [+/-7.6]) were included and were compared to 38 sex-matched controls (31 women, 7 men, mean age 82.7 [+/-6.9]). Among the 38 patients with hip fracture, 10 (26.3%) reported a pain in the hip region, compared with 2 (5.3%) in the control group (p=0.01).


CONCLUSIONS
A better recognition of "prefracture" pain in the elderly may allow adequate management and treatment of patients, in order to avoid a proportion of hip fractures.
Fleury
M
M
Department of Acute Care Geriatrics, General Hospital, Orleans, France.
Briot
K
K
Jenn
J
J
Dubois
M
M
Roux
C
C
Gauvain
J B
JB
D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000175:diagnosis* / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012307:Risk Factors; D013577:Syndrome