The new S.I.C.O. (Italian Society for Surgery of Osteoporosis) is trying to establish a register for osteoporotic complications, namely for Hip fractures, in fact at the moment only limited epidemiological data are available about the incidence of hip fractures in Italy. These data vary widely across the Italian Regions.

In the last five years E.S.O.P.O. study allowed us to have epidemiological data about osteoporosis in Italy, and from then a group of Orthopedic Units, distributed along all the country, are collecting data to better understand the epidemiological relevance of Hip Fractures.

84.188 Hip fractures were registered in 2001 from the Italian Ministry of health, which meant 1.48 fracture every 1.000 citizen, 25% of which were males.

From some areas through relating fractures and age was possible to establish that there were 3.7 fractures every 1.000 people over 50 years of age, 4.5 fractures every 1.000 females over 50 years of age, 1.9 every 1.000 males over 50.

From the Units working at the project few significant data were obtained: mean time between hospital arrival and surgery was 3.9 days, considered very high, the mean time of Hospital stay was 9.5 days for all patients, but 14.5 days for patients that underwent to an operation.

55% were lateral fractures for which a new “Italian” undersized titanium nail was introduced in February 2003, which rapidly was adopted in many hospital for its simplicity and low cost.

Controversial among Orthopedic surgeons arose because some of them are treating lateral fractures with total or partial hip replacement.

Because of different health organization between Regions of North, Center and South of Italy the patients are discharged to rehabilitation Unit mainly in North of Italy, less in Southern part where for a lack of Rehabilitation Units, most of the patients go back home, supported from public health operators at their family place.

Based on the data from the Health Ministry’s Epidemiological Survey Office, 84.188 Hip fractures were recorded in Italy (from DRG), in 2001 in patients over 50 years of age. They underwent many different types of treatment, but up to now no analyses on the medical outcomes are available for these patients. This means that it is not possible to state a reliable social cost and a right strategy for treatment. The need for creating a National Register for Hip fractures to collect data from different areas and to create the basis for standardized national care has been documented from Swedish Register (started in 1979), and from SAHFE European search (1998–2000). In Italy an attempt to start a national Register was done in 2001 with leading hospitals that represent each part of the country Veneto (Padova) and Liguria (Genova) for the North, Emilia Romagna (Parma) for the Centre, and Campania (Napoli), and Basilicata (Matera) for the South. The results are presented, and it appears clear that Hip fracture are one of the most important causes of death (20% in the first 6 months after fracture) and disability among older people (33% do not return to pre-fracture physical functioning). The incidence rate of hip fractures is about 1.4 fracture/1.000 inhabitans/year, and ranges from 6.5–7.5/1.000 individuals aged over 65. This study looked at different parameters at recruitment like: pre-fracture social and health conditions, ASA grade, type of fracture, type of operation, waiting time between hospital arrival and operation, length of hospital stay, inpatients’ mortality, if discharged back home or to nursing home or rehabilitation centers. At 6 month after discharge, a follow-up for assessing the health and social conditions was performed and the results will be presented. Data analysis was carried out using SAS package. (SAS/STAT User’s guide, vol 1–2; version 6, fourth edition 1994. SAS Institute Inc.)

Hip Fracture Registry Working Group: A Del Puente (Napoli), R. Laforgia (Matera), E. Palummeri (Genova), P.P. Benetollo (Schio) R. Rozzini (Brescia), M.L. Brandi (Firenze)

We report the results of low friction arthroplasty in 72 old tuberculous hips and 42 hips with old quiescent septic arthritis. Follow-up was for a minimum of two years. Recrudescence of tuberculosis was seen in only one patient, but deep infection occurred in four of the hips with previous septic arthritis. The reasons for this are discussed. It is recommended that patients with old tuberculous hips should have a course of anti-tuberculous drugs before operation, that patients with previous septic infection should have prophylactic antibiotics and antibiotic-loaded cement and that the operation should be performed by an experienced surgeon.