Epidemiology of proximal femur fractures in Kharkiv inhabitans

Vladimir Babalyan, Tamara Hurbanova, Andrii Kalchenko, Mykyta Valilshchykov


Fractures of the femur are the most severe in terms of medical and social consequences among injuries of bones of the lower extremities. An epidemiological analysis of the prevalence of fractures of the proximal femur (PHB) and the factors leading to their occurrence is the basis for planning of preventive measures and treatment in the elderly and senile.

Objective: to study the quantitative and qualitative characteristics of the epidemiological situation regarding PHB fractures in Kharkov residents.

Methods: the incidence of PHB was evaluated as a part of an epidemiological study in the population of Kharkov according to 5 medical institutions for 6 years — from 2011 to 2016. 3.949 patients were included in the analysis.

Results: there was a sharp increase (from 5 to 12 %) in the number of PHB fractures after 50 years, after 60 — almost to 20 %. The majority of patients (60 %) were in the age group 71 years and older. With an increase in age, PHB fractures with damage to the neck were more often recorded. Until the age of 60, more often men turned to medical institutions for injuries of PHB. But after 60 years, the number of women with these fractures increased and by the age of 70 was 1.9 times more than men (p < 0.001). Most elderly patients had concomitant diseases (mainly cardiovascular disease and hypertension), which should be considered when choosing treatment tactics.

Conclusions: the occurrence, treatment and prevention of fractures of the proximal femur is an acute medical and social problem. The risk of fractures increases with age, and treatment in elderly patients is usually complicated due to the presence of comorbidity. The results of an epidemiological study can help create the basis for the development in Ukraine of a regional program for the prevention and treatment of patients with PHB fractures.


fractures of the proximal femur; frequency; age; gender


Dhanwal, D., Dennison, E., Harvey, N., & Cooper, C. (2011). Epidemiology of hip fracture: Worldwide geographic variation. Indian Journal of Orthopaedics, 45 (1), 15. doi:10.4103/0019-5413.73656

Filipov, O. (2014). Eрidemiology and social burden of the femoral neck fractures. Journal of IMAB - Annual Proceeding (Scientific Papers), 20 (4), 516–518. doi:10.5272/jimab.2014204.516

Ryg, J., Rejnmark, L., Overgaard, S., Brixen, K., & Vestergaard, P. (2009). Hip fracture patients at risk of second hip fracture: a nationwide population-based cohort study of 169,145 cases during 1977–2001. Journal of Bone and Mineral Research, 24 (7), 1299–1307. doi:10.1359/jbmr.090207

Povoroznyuk, V. V., Grigoryeva, N. V., & Orlik, T. V. (2014). Osteoporosis in the practice of an internist. Kyiv. (in Russian)

Bhandari, M., Devereaux, P. J., Swiontkowski, M. F., Tornetta, P. 3rd, Obremskey, W., Koval, K. J., Nork, S., Sprague, S., Schemitsch, E. H., & Guyatt, G. H. (2003). Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. The Journal of Bone and Joint Surgery. Am., 85 (9), 1673–1681. doi: 10.2106/00004623-200309000-00004

Kanzyuba, A. I., Donchenko, L. I., Kanzyuba, M. A., & Chuchvareva, S. S. (2012). Hip joint replacement for fractures of the femoral neck against the background of involutive osteoporosis. Problems of osteology, 1, 70–73. (in Russian)

Loskutov, A. E., & Degtyar, A. V. (2011). Endoprosthetics of elderly patients with medial fractures of the femoral neck and their consequences. Problems of osteology, 1, 35–39. (in Russian)

Amato, L., Colais, P., Davoli, M., Ferroni, E., Fusco, D., Minozzi, S., Moirano, F., Sciattella, P., Vecchi, S., Ventura, M., & Perucci, C. A. (2013). Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data. Epidemiologia & Prevenzione, 37, Suppl. 2, 1–100.

Cooper, C., Cole, Z. A., Holroyd, C. R., Earl, S. C., Harvey, N. C., & Kanis, J. A. (2011). Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporosis International, 22 (5), 1277–1288. doi:10.1007/s00198-011-1601-6

Kanis, J. A., Odén, A., McCloskey, E. V., Johansson, H., Wahl, D. A., & Cooper, C. (2012). A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis International, 23 (9), 2239–2256. doi:10.1007/s00198-012-1964-3

Ström, O., Borgström, F., Kanis, J. A., Compston, J., Cooper, C., McCloskey, E. V., & Jönsson, B. (2011). Osteoporosis: burden, health care provision and opportunities in the EU. Archives of Osteoporosis, 6 (1–2), 59–155. doi:10.1007/s11657-011-0060-1

Ballane, G., Cauley, J. A., Luckey, M. M., & Fuleihan, G. E. (2014). Secular trends in hip fractures worldwide: opposing trends east versus west. Journal of Bone and Mineral Research, 29 (8), 1745–1755. doi:10.1002/jbmr.2218

Harvey, N. C., Curtis, E. M., Van der Velde, R., Moon, R. J., Van den Bergh, J. P., Geusens, P., & Cooper, C. (2016). On epidemiology of fractures and variation with age and ethnicity. Bone, 93, 230–231. doi:10.1016/j.bone.2016.07.011

Gullberg, B., Johnell, O., & Kanis, J. (1997). World-wide projections for hip fracture. Osteoporosis International, 7 (5), 407–413. doi:10.1007/pl00004148

Çankaya, D., Yoldaş, B., Çankaya, E., Çakir, Y., Aydin, C., & Tabak, A. Y. (2016). Analysis of the hip fracture records of a central training and research hospital by selected characteristics. Turkish Journal of Medical Sciences, 46, 35–41. doi:10.3906/sag-1406-150

Mattisson, L., Bojan, A., & Enocson, A. (2018). Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskeletal Disorders, 19 (1). doi:10.1186/s12891-018-2276-3

Wu, T., Hu, H., Lin, S., Chie, W., Yang, R., & Liaw, C. (2016). Trends in hip fracture rates in Taiwan: a nationwide study from 1996 to 2010. Osteoporosis International, 28 (2), 653–665. doi:10.1007/s00198-016-3783-4

Zelenka, L., Alt, J., Knížková, I., Kunc, P, & Lukešová, D. (2018). Epidemiological study of the effects of gender, age, mobility and time of injury on proximal femoral fractures [Czech]. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 85 (1), 40–45.

Povorozniuk, V., Grigoryeva, N., Korzh, M., Strafun, S., Kanis, J., McCloskey, E., Vaida, V., Klymovytsky, F., Vlasenko, R., & Forosenko, V. (2016). Еpidemiology of proximal femur fractures in ukraine: results of two retrospective studies. Orthopedics, traumatology and prosthetics, 4, 68–74. doi: 10.15674 / 0030-59872016468-74. (in Ukrainian)

Ramanau, H., Chernyanin, I., Rudenka, E., Lesnyak, O., Zakroyeva, A., Bilezikian, J. P., & Kanis, J. A. (2018). Epidemiology of hip fracture in Belarus: development of a country-specific FRAX model and its comparison to neighboring country models. Archives of Osteoporosis, 13 (1), 42. doi:10.1007/s11657-018-0454-4

Lunde, A., Tell, G. S., Pedersen, A. B., Scheike, T. H., Apalset, E. M., Ehrenstein, V., & Sørensen, H. T. (2018). The Role of Comorbidity in Mortality After Hip Fracture: A Nationwide Norwegian Study of 38,126 Women With Hip Fracture Matched to a General-Population Comparison Cohort. American Journal of Epidemiology, 188 (2), 398–407. doi:10.1093/aje/kwy251

Copyright (c) 2019 Vladimir Babalyan

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