[Epidemiology of trochanteric femoral fractures over 2 decades (1972-1988)]

Owing to gradual aging of the population, the incidence of osteoporosis-related fractures of the proximal femur has increased. Trochanteric fractures are encountered in more than 50% of hip fractures. In this study, a comparative epidemiological analysis of patients with trochanteric fractures treated in the orthopedic department of the university hospital of Berne was performed. The time period from 1972 to 1978 (group 1, n = 205), was compared with the period from 1981 to 1989 (group 2, n = 444). Group 2 experienced a significant age-related increase of the number of patients with trochanteric fractures in the age group 30-49 years (p < 0.0001) and a significant increase of the number of patients in the age group over 80 years (p < 0.0001). In group 2, the female/male ratio was 0.24/1 for patients aged 30-49 years, 0.88/1 in the age group 50-59 years, 0.92/1 and 2.47/1 for patients in the age groups 60-69 and 70-79 years, respectively, and 3.59/1 in individuals over 80 years of age. The increased incidence in older women with trochanteric fractures is related to a higher grade of osteoporosis and agrees with the findings in the literature. The marked increase in the incidence of fractures in young males could be due to a higher risk of high-energy trauma sustained in traffic accidents and sports. Another explanation is the increase of risk factors for early osteoporosis related to low-energy traumas over the past two decades. Overall, there was a tendency towards more complicated fracture types (AO classification) in group 2 than in group 1.