title: Beneficial effects of bipolar hemiarthroplasty replacement and fosamax in the retrospective cohort study of refracture and mortality of hip fractured patients.
abstract: The epidemiological hip fracture leads to a high death rate in the elderly with osteoporosis worldwide. However, the appropriate surgical styles or anti-osteoporotic therapy could prevent these patients with hip fractures from suffering refracture, but the efficacy of such treatment remains elusive for first hip fractured patients. Our retrospective analysis was conducted on 508 hip fracture patients who were enrolled from Show Chwan Memorial Hospital from January 2005 through December 2011 and followed up until the end of 2012. However, bipolar hemiarthroplasty replacement and open reduction internal fixation (ORIF) are treatment options for femoral neck and intertrochanic hip fracture in our study population. Among these patients, 82 suffered 2nd hip fracture (refracture) with femoral neck or intertrochanteric fracture and 39 died after surgical intervention accompanied complications. Kaplan-Meier analysis revealed a better outcome in patients with bipolar hemiarthroplasty replacement or fosamax therapy of hip fractured patients than those with femoral neck/ORIF and intertrochanteric/ORIF or without fosamax therapy. Multivariate cox regression analysis revealed the lowest incidence of refracture and mortality in hip fracture patients with received bipolar hemiarthroplasty replacement surgical intervention (OR=0.732, CI=0.587-0.912; P=0.006). It is therefore concluded that fosamax therapy may improve bone density and increase bone tissue repair to prevent patients with hip fracture from refracture, and bipolar hemiarthroplasty replacement may promote patients who undertake outdoor activities to produce more vitamin D than those who have received ORIF.
authors.affiliation: Department of Orthopedics, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Jen-Sheng
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Research Assistant Center, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Po-Ming
authors.initials: PM
authors.lastname: Chen
authors.affiliation: Research Assistant Center, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Research Assistant Center, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Rong-Fu
authors.initials: RF
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Changhua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Pei-Yuan
authors.initials: PY
authors.lastname: Lee
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005592:Fracture Fixation / Q000009:adverse effects / Q000401:mortality; D062785:Hemiarthroplasty / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate