Abstract
Background: Although hip fracture is often the first presentation of osteoporosis, prophylactic measures are not routinely prescribed. Aims: To investigate whether the second hip fracture has a significant further impact on walking and social independence and to identify which patients are most likely to benefit from currently available prophylactic measures. Method: Information on walking ability and social independence was obtained approximately 3 months following discharge for 49 consecutive patients admitted with a second hip fracture. Results: Fewer patients maintained their ability to walk without the help of an able-bodied assistant after the second fracture compared with the first fracture (53% and 91% respectively p< 0.0005). A similar proportion of patients admitted from their own homes remained socially independent after the first and second fractures (64% and 54% respectively). Social independence was determined by mental status after the first fracture but by ability to walk unassisted after the second fracture. The median time to second fracture was 31 months (3–302). The median time to second fracture for patients aged 80 and below and patients without a history of recurrent falls was more than 2 years. Conclusion: The second fracture had a significant further impact on patients. Bisphosphonates given over a 2 year period can decrease the rate of hip fracture and should be given to patients who sustain a hip fracture aged 80 or less and patients who do not have a history of multiple falls. Hip protectors should be considered in other patients.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
