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Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients

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Abstract

Purpose

In the Netherlands, over 20,000 patients sustain a hip fracture yearly. A first hip fracture is a risk factor for a second, contralateral fracture. Data on the similarity of the treatment of bilateral femoral neck fractures is only scarcely available. The objectives of this study were to determine the cumulative incidence of non-simultaneous bilateral femoral neck fractures and to describe the patient characteristics and treatment characteristics of these patients.

Methods

A database of 1,250 consecutive patients with a femoral neck fracture was available. Patients with a previous contralateral femoral neck fractures were identified by reviewing radiographs and patient files. Patient characteristics, previous fractures, hip fracture type and details on treatment were collected from the patient files.

Results

One hundred nine patients (9 %, 95 % confidence interval 7–10 %) had sustained a non-simultaneous bilateral femoral neck fracture. The median age at the first fracture was 81 years; the median interval between the fractures was 25 months. Overall, 73 % was treated similarly for both fractures in terms of non-operative treatment, internal fixation or arthroplasty. In patients with identical Garden classification (30 %), treatment similarity was 88 %.

Conclusions

The cumulative incidence of non-simultaneous bilateral femoral neck fractures was 9 %. Most patients with identical fracture types were treated similarly. The relatively high risk of sustaining a second femoral neck fracture supports the importance of secondary prevention, especially in patients with a prior wrist or vertebral fracture.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Paul T. P. W. Burgers, Stephanie M. Zielinski, Adinda K. E. Mailuhu, Michiel H. J. Verhofstad & Esther M. M. Van Lieshout

  2. Department of Surgery, Kennemer Gasthuis, Haarlem, The Netherlands

    Martin J. Heetveld

  3. Department of Surgery, St. Elisabeth Ziekenhuis, Tilburg, The Netherlands

    Michiel H. J. Verhofstad

  4. Department of Surgery, Maasstad Ziekenhuis, Rotterdam, The Netherlands

    Gert R. Roukema

  5. Accident and Emergency Department, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Peter Patka

  6. Joint Research, Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

    Rudolf W. Poolman

Authors
  1. Paul T. P. W. Burgers
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  2. Stephanie M. Zielinski
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  3. Adinda K. E. Mailuhu
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  4. Martin J. Heetveld
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  5. Michiel H. J. Verhofstad
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  6. Gert R. Roukema
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  7. Peter Patka
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  8. Rudolf W. Poolman
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  9. Esther M. M. Van Lieshout
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Consortia

on behalf of the Dutch femoral neck fracture investigator group

Corresponding author

Correspondence to Esther M. M. Van Lieshout.

Additional information

The following hospitals in the Netherlands participated in this study. The principal investigators are mentioned:

Academisch Medisch Centrum, Amsterdam; J. Carel Goslings (Trauma Unit Dept. of Surgery)

Bronovo Ziekenhuis, Den Haag; Maarten W.G.A. Bronkhorst (Dept. of Surgery)

Erasmus MC, University Medical Center Rotterdam, Rotterdam; Peter Patka (Dept. of Surgery-Traumatology)

Kennemer Gasthuis, Haarlem; Martin J. Heetveld (Dept. of Surgery)

Maasstad Ziekenhuis, Rotterdam; Gert R. Roukema (Dept. of Surgery)

Medisch Centrum Haaglanden, Den Haag; Steven J. Rhemrev (Dept. of Surgery)

Onze Lieve Vrouw Gasthuis, Amsterdam; Maarten P. Simons (Dept. of Surgery), Rudolf W. Poolman (Dept. of Orthopedic Surgery)

Reinier de Graaf Groep, Delft; Maarten Van der Elst (Dept. of Surgery)

St. Antonius Ziekenhuis, Nieuwegein; Michiel J.M. Segers (Dept. Of Surgery), Jacco A.C. Zijl (Dept. of Orthopedic Surgery)

St. Elisabeth Ziekenhuis, Tilburg; Michiel H.J. Verhofstad (Dept. of Surgery)

Tergooi Ziekenhuizen, Hilversum; Jan Peter Eerenberg (Dept. of Surgery), Harm M. Van der Vis (Dept. of Orthopedic Surgery)

UMC St Radboud, Nijmegen; Jan Biert (Dept. of Surgery), Albert Van Kampen (Dept. of Orthopedic Surgery)

UMC Utrecht, Utrecht; Rogier K.J. Simmermacher (Dept. of Surgery), Paavo L. Freijzer (Dept. of Orthopedic Surgery)

IJsselland Ziekenhuis, Rotterdam; Piet A.R. De Rijcke (Dept. of Surgery)

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Burgers, P.T.P.W., Zielinski, S.M., Mailuhu, A.K.E. et al. Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients. International Orthopaedics (SICOT) 38, 2335–2342 (2014). https://doi.org/10.1007/s00264-014-2447-2

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  • DOI: https://doi.org/10.1007/s00264-014-2447-2

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