Oral Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Background:

Hip fractures (HF) in young adults (YAs;18-50 years) are infrequent and typically follow high-energy trauma (HET); published surgical follow-up data is reassuring¹. Long-term outcomes for hip minimal trauma fractures (MTF) associated with chronic disease are unknown. 

Aim: 

To evaluate the co-morbidities, secondary prevention, functional outcomes and quality of life (QoL) of YAs with HF. 

Methods:

YAs with HF were identified by extracting ICD-10 coding for discharge diagnosis (2009-2020). Phone interviews were conducted to identify current QoL (pain, mobility, functional independence and employment), fracture follow-up and secondary prevention. Data on fracture mechanism, comorbidities, medications, imaging and specialist referral were extracted through electronic medical records. Patients admitted 2009 – 2015 were previously characterised².

Results:

88 eligible YAs (mean age 40.2±7.7 years; 40.9% female; 64/88 MTF) with HF were identified after excluding stress fractures (2), unknown mechanism (3) or incomplete data (3). 31/88 (35.2%) completed the interview. Chronic disease (39/64, 60.9% MTF vs 4/24, 16.7% HET) and use of high-risk medications (35/64, 54.7% MTF vs 5/24, 20.8% HET) was highly prevalent in MTF patients (Table 1). Importantly, 10/88 (11.4%) were deceased, all post-MTF. Phone interviews revealed that 13/31 (41.9%) experienced ongoing hip pain, 6/31 (19.4%) now require a gait aid, and 9/31 (29.0%) experience new limitations to activities of daily living. 5/25 (20%) respondents are newly unemployed, while 7/20 (35%) returned to work at reduced capacity. Only 6/21 (28.6%) with MTF received bone-targeted therapy (Table 2).

Conclusion:

This is the first study to highlight the mortality, morbidity, impaired QoL associated with HF in YAs and the low rates of pharmaceutical treatment. This is an important gap in current hip fracture management that needs urgent attention.