HIP FRACTURE IN A YOUNG PATIENT AFTER LOW-ENERGY TRAUMA

Abstract

Purpose: To understand the epidemiology and risk factors of an osteoporotic hip fracture in a non-elderly patient.

Methods: Retrospective study covering the period 1999–2004, assessing individual and family history, fracture type, hospital stay, time until surgery, type of treatment and possible study or treatment of bone fragility.

Results: 38 cases. 23 patients (60.5%) presented some risk factor related to osteoporosis: enolism 7, liver pathology 3, neuromuscular disease 13, steroid treatment 4 and anticonvulsant 3. Seven patients (18.4%) presented some type of psychiatric disorder. Mean hospitalisation time: 13 days. Time until surgery: 3 days. Fracture type: 20 (52.6%) pertrochanteric and 16 (42.10%) subcapital. Treatment: cannulated screws in 11 cases (29%), screw and plate in 21 (55.2%). We found no diagnosis of osteoporosis or related indications in the admission reports except in one patient. Patients over 50: hip fracture incidence 161.21/100,000 inhabitants, pertrochanteric in 54.9% and subcapital in 45.1%*.

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Conclusions:

1. Hip fractures resulting from low-energy trauma are uncommon in the population under the age of 50.

2. There are factors predisposing to bone fragility in 60.5%.

3. The type of fracture is similar to those found in the elderly.

4. Treatment with cannulated screws is more common in non-elderly patients (20% vs 7%*)

5. There is not adequate consideration of the problem of osteoporosis in these patients.