SEASONAL VARIATION OF PROXIMAL FEMORAL FRACTURES

Abstract

Proximal femoral fractures have always been in the centre of attention in terms of their demand on the manpower and resources of the NHS. With an ageing population, the number of these fractures will continue to be a big part of the workload of all the Orthopaedic and rehabilitation units. Hence it is important to be aware of any definite variation in the incidence of proximal femoral fractures for appropriate planning of the available resources.

We carried out a study to find out whether there is a definite variation in the incidence of these fractures. The number of operated proximal femoral fractures across 31 hospitals of North-west England and Scotland were collected on a monthly basis from 1994 to 1999. This database of 27, 000 operated proximal femoral fractures was assessed statistically.

Our analysis reveals that the incidence of these fractures during December is about 17% higher than the rest of the annual mean with a 2% standard error of the mean (SEM) and in January this increase is about 22% with an SEM of 1%. These trend and pattern were observed for both intra and extra capsular fractures of neck of femur and was consistent over the five years. There was no other significant change in the incidence pattern during other months of the year.

This study, one of the largest of its kind ever carried out in Britain, proves that there is an increase in the incidence of hip fractures in the months of December and January. There should be appropriate allocation of manpower and rehabilitation facilities along with a matching reduction in the elective Orthopaedic admissions during the months of December and January to tackle this seasonal variation.