Fractured hips in rural Melanesians: a nonepidemic

Fractured hips are increasingly common in elderly citizens of many developed countries. Such fractures seem to be rare in less affluent people of some developing countries, even amongst the elderly. A four year review was done of all trauma patients admitted to a provincial hospital in hospital in Papua New Guinea which serves 135.000 people living mainly in remote hamlets. Only three fractures of the proximal femur were noted. One of these was in a bedridden plantation owner. Not a single fracture of the femoral neck was noted in the Melanesian population. Colles fractures of the distal radius were also rarely seen. Other fractures were common. Elderly Melanesian villagers are physically active, and it appears that this is an important factor in preventing bone weakness and associated fractures of the hip and distal radius. Modern cities and urban lifestyles need radical change to keep elderly people more physically active.