title: Orthopaedic injuries associated with hip fractures in those aged over 60 years: a study of patterns of injury and outcomes for 1971 patients.
abstract: BACKGROUND
  There has been little research into the consequence of suffering a hip fracture and associated orthopaedic injures. The aim of this research paper is to describe the patient characteristics, patterns of injury and to define the effect on outcomes of orthopaedic injuries occurring simultaneously with hip fractures.
  
  
  METHODS
  Hip fracture data was collected prospectively. Patients under 60 years of age were excluded from the study. Between 2004 and 2010 we treated 1971 consecutive patients aged 60 years or older with a hip fracture.
  
  
  RESULTS
  81 (4.1%) patients sustained a simultaneous fracture or dislocation. 90% (73/81) of these injuries were in the upper limb and 88% (71/81) were ipsilateral, with the wrist (34 cases) and the proximal humerus (21 cases) being the commonest site of injury. Median hospital stay was significantly longer for those with additional injures. Pubic rami fractures were not seen in association with a hip fracture. Those patients who sustained a concomitant wrist fracture tended to be slightly fitter than those without associated injuries whist those with an associated humeral fracture were slightly frailer. Mortality was increased for those with an associated proximal humeral fracture but was lower with an associated wrist fracture.
  
  
  CONCLUSIONS
  Simultaneous injuries occurring with hip fractures are mainly seen in the ipsilateral upper limb. They present a greater challenge to the multidisciplinary team than a solitary hip fracture, experiencing a longer hospital stay and inevitably a higher financial cost. Those patients with wrist fractures have the best prognosis in terms of mortality, whereas a proximal humerus fracture may indicate a higher risk of mortality.
authors.affiliation: Department of Orthopaedics, Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough PE3 9GZ, United Kingdom. paulrobinson79@doctors.org.uk
authors.forename: P M
authors.initials: PM
authors.lastname: Robinson
authors.forename: T
authors.initials: T
authors.lastname: Harrison
authors.forename: A
authors.initials: A
authors.lastname: Cook
authors.forename: M J
authors.initials: MJ
authors.lastname: Parker
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D006620:Hip Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014954:Wrist Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology