title: Epidemiology and outcome of fracture of the hip in women aged 65 years and under: a cohort study.
abstract: We examined prospectively collected data from 6782 consecutive hip fractures and identified 327 fractures in 315 women aged ≤65 years. We report on their demographic characteristics, treatment and outcome and compare them with a cohort of 4810 hip fractures in 4542 women aged > 65 years. The first significant increase in age-related incidence of hip fracture was at 45, rather than 50, which is when screening by the osteoporosis service starts in most health areas. Hip fractures in younger women are sustained by a population at risk as a result of underlying disease. Mortality of younger women with hip fracture was 46 times the background mortality of the female population. Smoking had a strong influence on the relative risk of 'early' (≤ 65 years of age) fracture. Lag screw fixation was the most common method of operative treatment. General complication rates were low, as were re-operation rates for cemented prostheses. Kaplan-Meier implant survivorship of displaced intracapsular fractures treated by reduction and lag screw fixation was 71% (95% confidence interval 56 to 81) at five years. The best form of treatment remains controversial.
authors.affiliation: Nottingham University, Hospitals NHS Trust, Queen's Medical Centre Campus, Derby Road, Nottingham NG7 2UH, UK. alexiak41@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Karantana
authors.forename: C
authors.initials: C
authors.lastname: Boulton
authors.forename: G
authors.initials: G
authors.lastname: Bouliotis
authors.forename: K Shan Shan
authors.initials: KS
authors.lastname: Shu
authors.forename: B E
authors.initials: BE
authors.lastname: Scammell
authors.forename: C G
authors.initials: CG
authors.lastname: Moran
mesh_terms: D000058:Accidental Falls; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001863:Bone Screws; D004812:Epidemiologic Methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult