gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)

24.10. - 27.10.2017, Berlin

Atypical subtrochanteric fractures in the Korean hip fracture study

Meeting Abstract

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  • presenting/speaker Young-Kyun Lee - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)
  • Woo-Lam Jo - Catholic University of Seoul, Korea, Seoul, Korea, Republic of (South Korea)
  • Jun-Il Yoo - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)
  • Byung-Ho Yoon - Inje University College of Medicine, Seoul, Seoul, Korea, Republic of (South Korea)
  • Yong-Chan Ha - Chung-Ang University College of Medicine, Seoul, Korea, Republic of (South Korea)
  • Kyung-Hoi Koo - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocPO16-402

doi: 10.3205/17dkou684, urn:nbn:de:0183-17dkou6848

Veröffentlicht: 23. Oktober 2017

© 2017 Lee et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Recently, atypical subtrochanteric fractures (ASF) have been reported to increase among patients on bisphosphonate. Although concerns about ASF appears to be increasing worldwide and the incidence of ASF is various, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in East Asian population. The purpose of this study was (1) to determine the proportion of ASF among patients with proximal femur fractures, and (2) to identify risk factors associated with the occurrence of ASF among East Asian patients.

Methods: Our Korean Hip Fracture study is a prospective cohort study begun in 2014 in which 1468 patients with hip fracture over age 50 years were recruited from 16 academic centers and were followed up prospectively for second fractures. We also documented information to determine the incidence and risk factors for subtrochanteric, femoral neck, and intertrochanteric fractures in Korean population. As a part of Korean Hip Fracture study, we evaluated the proportion of ASF among proximal femur fracture. To identify ASF, according to the definition by ASBMR task force, all radiographs of subtrochanteric fracture were reviewed. Associated risk factors for occurrence of ASF was also evaluated by using multivariate logistic regression analysis.

Results: Among 1,361 patients with proximal femur fracture, there were 60 subtrochanteric femur fractures. The average age of patients with subtrochanteric fractures was 74.9 ± 9.9 years, and 46 of the subjects (76.7%, 46/60) were female. Among 60 subtrochanteric fractures, a total of 17 fractures were reported atypical fracture. After re-review of radiographs, all 17 fractures (1.2 %, 17/1,361) were identified as ASF. In multivariate analysis, higher BMI (OR, 1.17; 95% CI, 1.13-1.88) and use of bisphosphonate before injury (OR, 7.18; 95% CI, 1.08-69.82) were independent risk factors of ASF.

Conclusion: In Korean, ASF were rare. Unlike risk factors of osteoporotic hip fracture, Higher BMI and use of bisphosphonate were significant risk factors of ASF.