Outcome after sequential hip fracture in the elderly

Graeme Holt, Rik Smith, Kathleen Duncan, James D Hutchison, Alberto Gregori, Damien Reid

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Hip fracture is a common cause of morbidity and mortality in the elderly. As the risk factors for hip fracture often persist after the original injury, patients remain at risk for sequential fractures. Our aim was to report the incidence, epidemiology, and outcome of sequential hip fracture in the elderly.

Data were collected during the acute hospital stay and at 120 days after admission from twenty-two acute orthopaedic units across Scotland between January 1998 and December 2005. These data were analyzed according to two separate time periods: by six-month intervals up to eight years after the primary fracture and by twenty-day intervals for the first two years after the primary fracture.

The risk of sequential fracture was highest in the first twelve months, affecting 3% of surviving patients and decreasing to 2% per survival year thereafter. Survival to twelve months after sequential fracture was 63% compared with 68% for those with a single fracture (p = 0.03). Sequential hip fracture was also associated with greater loss of independent mobility and changes in residential status compared with single fractures.

Sequential hip fracture is a relatively rare injury. Individuals who sustain this injury combination have poorer outcomes both in terms of survival and functional status.
Original languageEnglish
Pages (from-to)1801-1808
Number of pages8
JournalThe Journal of Bone & Joint Surgery. American Volume
Issue number19
Publication statusPublished - 3 Oct 2012


  • age distribution
  • aged
  • aged, 80 and over
  • confidence intervals
  • databases, factual
  • female
  • follow-up studies
  • fracture fixation, internal
  • fracture healing
  • geriatric assessment
  • hip fractures
  • hospital mortality
  • humans
  • incidence
  • injury severity score
  • logistic models
  • male
  • middle aged
  • odds ratio
  • range of motion, articular
  • recurrence
  • retrospective studies
  • risk assessment
  • sex distribution
  • survival analysis


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