Related Experiment Video
Updated: May 12, 2026
Development of a Novel Internal Fixation Model for Rat Radial Fractures: Fracture Healing Assessment and Dorsal Root Ganglion Isolation
Published on: March 13, 2026
One-year mortality after first-time long bone fractures in older adults: A multicenter retrospective cohort study
Amir Mahdi Ghafarian1, Muaaz Wajahath2, Katie McBee3
1International University of the Health Sciences, Basseterre, Saint Kitts and Nevis; FAJR Scientific, Houston, TX, USA.
Background:
Fragility fractures represent a major public health concern in the aging population, contributing substantially to morbidity, functional decline, and mortality. Although hip fractures are widely recognized for their high early mortality risk, less is known about the comparative one-year mortality associated with first-time long bone fractures at other anatomical sites. This study evaluates one-year all-cause mortality across multiple fracture types in older adults using a large, multicenter research network.
Methods:
We performed a retrospective cohort study using the TriNetX US Collaborative Network, identifying patients ≥ 65 years with a first-time long bone fracture between 2004 and 2024. Fracture types included hip, pertrochanteric, subtrochanteric, distal femur, proximal tibia, distal tibia, proximal humerus, and distal humerus fractures. Patients with pathologic, metastatic, or multiple fractures were excluded. A non-fracture cohort of age-matched older adults served as the comparison group. The primary outcome was one-year all-cause mortality. Propensity score matching (1:1) was used to balance demographics. Relative risks (RR) with 95% confidence intervals (CIs) and Kaplan-Meier survival analyses were performed.
Results:
A total of 165,017 fracture patients and 4.55 million non-fracture controls were identified; 162,469 patients remained after matching per cohort. All fracture types were associated with significantly increased one-year mortality compared with matched controls (2.77%). Hip fractures demonstrated the highest risk (27.9%; RR 4.86, 95% CI 4.65-5.08), followed by pertrochanteric (23.9%; RR 4.14) and subtrochanteric fractures (15.2%; RR 2.98). Distal femur fractures carried a 9.4% mortality risk (RR 2.71). Mortality for distal humerus, distal tibia, proximal tibia, and proximal humerus fractures ranged from 5.6 to 7.1% (RR 1.63-1.97).
Conclusion:
First-time long bone fractures in older adults are associated with significantly elevated one-year mortality, with hip and proximal femur fractures conferring the greatest risk. These findings underscore the need for early risk stratification, targeted postoperative care, fall-prevention strategies, and multidisciplinary management to reduce fracture-related mortality in the geriatric population.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...