Risk factors for osteoporosis are common in young and middle-aged patients with femoral neck fractures regardless of trauma mechanism.
OBJECTIVE
There have been few prospective studies examining young and middle-aged patients with hip fracture. We therefore investigated background data, risk factors, and the trauma mechanism in young and middle-aged patients with femoral neck fracture.


METHODS
185 patients, 27 young (20-49 years old) and 158 middle-aged (50-69 years old) were prospectively included in a multicenter study lasting 3 years. Background data and risk factors for osteoporosis and fracture were obtained, and the type of injury was classified as low-energy trauma, high-energy trauma, or sports injury.


RESULTS
In the young age group, the fracture occurred because of low-energy trauma in two-fifths of patients and because of sport injury in two-fifths of patients. The rest occurred because of high-energy trauma. The corresponding proportions for the middle-aged group were four-fifths, one tenth, and one tenth (p < 0.001). There was a higher proportion of men (19/27) in the young group than in the middle-aged group (69/158) (p = 0.001). One fifth of the young patients were smokers as compared to two-fifths in the middle-age group (p = 0.04). One quarter of the patients reported high-volume alcohol drinking, with no difference between the two groups. Furthermore, three-quarters of the young patients and four-fifths of the middle-aged patients had one or more risk factors for osteoporosis and fracture.


CONCLUSIONS
A minority of patients in each age group had high-energy trauma as the cause of their femoral neck fracture. Lifestyle factors and other non-trauma-related risk factors appear to have been important contributors to the occurrence of femoral neck fracture in both age groups.
Institute of Clinical Science, Intervention and Technology (CLINTEC), Department of Orthopaedics, Karolinska University Hospital, Sweden. amer.al-ani@karolinska.se
Amer N
AN
Al-Ani
Gustaf
G
Neander
Bodil
B
Samuelsson
Richard
R
Blomfeldt
Wilhelmina
W
Ekström
Margareta
M
Hedström
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D001265:Athletic Injuries / Q000209:etiology; D016009:Chi-Square Distribution; D005260:Female; D005265:Femoral Neck Fractures / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000209:etiology; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D055815:Young Adult