Secondary database analyses of de-identified hospital discharge abstracts from the catchment area of the two acute care hospitals in the city of London, Ontario, Canada (approximately 500,000 inhabitants) was conducted to examine the distribution of anatomic hip fracture types as a function of age and gender. The current study's objectives were to further explore, among a cohort of men and women with hip fracture, the relative proportion of intertrochanteric and subcapital fractures and how the proportion changes with age in the two genders. (2007), likewise, found a rise in women but not in men. (1996) found a rising proportion of intertrochanteric fractures in white women but not in white men, or blacks of either gender, and Bjorgul et al. Beyond research which has shown that advancing age is more strongly associated with risk of intertrochanteric fractures than subcapital fractures, evidence for other such differences between the fracture populations remains largely unexplored, especially in recent years. Thus those with intertrochanteric fractures tend to have lower bone density and more vertebral fractures suggesting they are more osteoporotic, although this finding is not totally consistent. As the two major sites have a dissimilar composition of bone, the trochanteric region having a greater proportion of trabecular bone, it has been suggested that the etiology of each fracture may in fact differ and investigating hip fractures as a single entity may obscure risk factors and occurrence patterns. Many studies have grouped hip fractures as a homogeneous condition, though there are two major anatomic types: intracapsular fractures (cervical or subcapital hip fractures) of the femoral neck and extracapsular hip fractures of the intertrochanteric region (pertrochanteric fractures). As the risk of hip fracture increases dramatically with age, it is a widely held view that the number of hip fractures will rise substantially as the population of Canada and the United States continues to grow older. Hip fractures are regarded as the most common severe type of fall-related injury among older adults and the most serious of the osteoporotic fractures because of their high morbidity, mortality and impairment in quality of life. The two main hip fracture types should be considered distinct and different and be studied separately in studies of cause and prevention. It is likely that the pattern difference reflects differences in type and rate of bone loss in the genders, but it is conjectured that the changing rate and pattern of falling with increasing age may also be important. The pattern of hip fractures is different in men and women with aging. 001), but in men the opposite pattern is observed, with the proportion of intertrochanteric fractures falling significantly with age (p =. In women this increase is significant (p <. Overall, for the genders combined, the proportion of intertrochanteric fractures increases with age (p =. Patients of 50 years and older, with a diagnosis of hip fracture, discharged from two local acute care hospitals over a 5 year period (n = 2150) were analyzed as a function of age and gender to explore the relative proportions of intertrochanteric and subcapital fractures, and the change in relative proportion in the two genders with age. In this study, we explored changes in the relative proportion of the two fracture types with age in the two genders. In previous studies no particular pattern in men has been noted. The relative proportion of intertrochanteric fractures increases with age in women. In most studies hip fractures have been viewed as a unitary fracture but recently the two main types of fracture (intertrochanteric and subcapital) have been viewed as two fractures with a different etiology and requiring a different approach to prevention. Hip fractures are expensive and a frequent cause of morbidity and mortality in the elderly.
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