Prefracture syndrome of the hip fracture: a case control study

CER3287
2008 Vol.26, N°3
PI 0464, PF 0466
Brief Papers

Free to view
(click on article PDF icon to read the article)

PMID: 18578971 [PubMed]

Abstract

BACKGROUND:Hip fractures result from both bone fragility and trauma, more often a sideways fall. Spontaneous hip fractures have been described; in such cases, patients reported pain (`prefracture` syndrome) in the hip region for weeks before the fracture. OBJECTIVES:
To identify the proportion of patients who had a pain in the hip region before a hip fracture, to compare this proportion to the one observed in controls and to describe the characteristics of this pain. PATIENTS AND
METHODS:
For a period of 6 months, each subject (>65 years) treated for hip fracture was prospectively recruited in an orthopaedic surgery department. Exclusion criteria were: alterations of cognitive functions (defined by a mini mental state <20), refusal, and fractures related to bone metastasis or multiple myeloma. Subjects were compared to sex-matched controls consulting in an acute care geriatrics unit. They were asked about the occurrence of pain in hip region before the fracture and its characteristics.
RESULTS:
Thirty-eight patients (31 women, 7 men, mean age 83.1 [±7.6]) were included and were compared to 38 sex-matched controls (31 women, 7 men, mean age 82.7 [±6.9]). Among the 38 patients with hip fracture, 10 (26.3%) reported a pain in the hip region, compared with 2 (5.3%) in the control group (p=0.01).
CONCLUSIONS:
A better recognition of `prefracture` pain in the elderly may allow adequate management and treatment of patients, in order to avoid a proportion of hip fractures.