Abstract
Introduction
Hip fractures, with a global age-standardised incidence rate (per 100,000 population) of 187.2 (2019), are a major public health problem. With a 7.71 billion population worldwide in 2019, hip fractures, in general, are affecting around 14.43 million people per year globally.
We aim to provide a nationwide epidemiological analysis of trochanteric fractures and their respective surgical treatments. In this study we research the epidemiology of trochanteric and subtrochanteric fractures, as well as their most common kinds of osteosynthesis, on a nationwide scale in Germany.
Method
Data was retrieved from the national database of the German Ministry of Interior. ICD-10-GM and OPS-data from the period of 2006-2020 were analyzed, all patients with trochanteric/subtrochanteric fractures were included. Patients were grouped by age/gender and linear-regression was performed to calculate statistically significant correlations between variables/incidences.
Result
985,104 trochanteric and 178,810 subtrochanteric-fractures were reported during the analyzed period. This calculates to a mean incidence of 80.08±6.34 for pertrochanteric and 14.53±1.50 for subtrochanteric fractures per-million-inhabitants. In both fracture-types, a distinct dependence of incidence on age can be seen. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under 60 to those over the age of 90 in pertrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Dynamic compression screws were decreasing in frequency.
Conclusion
We found an ongoing increase of incidence among the elderly and an increase in intramedullary nailing as well as augmentative cerclages. Not only could we show an age-dependence of the incidences, but also a sex-dependence that seems to remain consistent in its development. While younger males (<60 years) are at a higher risk than their female peers, older females are at significantly higher risk than their male peers.
