Analysis of 245 consecutive hip fracture patients with special reference to bone metabolism

The number of hip fractures in industrialised countries is increasing rapidly, being a major socio-economic burden for the health care system. The aims of this study were to evaluate fracture treatment, complications, recovery and especially bone metabolism of the hip fracture patients.

245 consecutive hip fracture patients were examined. Information on the type of the fracture, surgical methods and outcome, previous chronic diseases and mortality were obtained from the hospital records. Bone biopsy of the iliac crest was performed on 105 patients at the time of the operation for histomorphometric evaluation. Later questionnaires were sent to the biopsy patients. A subgroup (n = 13) of fracture patients with osteomalacia were further evaluated for bone mineral density (BMD) and biochemistry.

The overall condition of the patients deteriorated in 72.1%. Only 58% of the patients were able to return to their previous place of residence. Only 20% of the patients had normal histomorphometry of trabecular bone. Osteomalacia was found in 24% and hyperparathyroid histological changes in 3% of the cases. To prevent hip fractures, not only adjustments in daily environment but also proper therapy of chronic diseases as well as diagnosis and treatment of metabolic bone diseases are needed. Also, accurate surgical methods and good rehabilitation are necessary to ensure optimal recovery of the patients with proximal femoral fractures.