When Hip Fractures Happen Again

Oct. 12, 2007 -- Hip fractures are a repeat problem for roughly one in seven adults who fracture a hip.

That's according to a fresh look at a study spanning more than 50 years.

The Framingham Heart Study included adults in Framingham, Mass. Participants got checkups every two years ever since 1948, providing reams of health research over the decades.

Forget the "heart" part of the study's name for a moment. The latest analysis focuses on hip fractures -- and specifically on second hip fractures -- among the study's participants.

Second Hip Fracture

From 1952 to 2003, 481 participants fractured a hip fracture and 71 participants -- almost 15% -- had a second hip fracture during that time.

Most of the hip fracture patients were women.

Second hip fractures typically affected the hip that wasn't fractured the first time.

Death rates rise after hip fractures. It's not that the hip fracture itself is deadly. Rather, it's the side effects of the fracture -- including limited activity -- that are dangerous.

In the Framingham Heart Study, about 16% of people who sustained a first hip fracture died within a year of that initial hip fracture, compared with 24% of those who died after a second hip fracture.

The higher death rate after second hip fractures was partly due to age.

Participants were typically 81 years old when they had their first hip fracture and 86 when they sustained their second hip fracture, note the researchers.

They included Sarah Berry, MD, MPH, of the medicine department at Beth Israel Deaconess Medical Center.

Hip fractures, which are most common in older adults, often happen after a fall and are more likely in people with osteoporosis (dangerously thin bones).

The participants didn't get bone density tests, so it's not clear how many of them had osteoporosis.

Berry's team says more research is needed on second hip fractures. Their study appears in the latest edition of the Archives of Internal Medicine.

Preventing Hip Fractures

Hip fractures are usually due to falls. The CDC and National Institute on Aging provide these fall prevention tips for older adults:

• Talk to your doctor to plan an exercise program that includes strength and balance training.
• Have your vision and hearing tested often.
• Ask your doctor if your medications may affect your coordination or balance.
• Check the lighting in your home, especially at the top and bottom of stairs.
• Have handrails on both sides of stairs.
• Make sure all carpets and rugs are firmly attached to the floor.
• Put no-slip strips on tile and wooden floors.
• Put grab bars on the inside and outside of your tub and shower.
• Stand up slowly after eating, lying down, or resting.
• Keep night lights on.
• Keep the areas where you walk tidy, without furniture in your way.
• Limit the amount of alcohol you drink.
• Wear low-heeled shoes with rubber soles that fully support your feet.
• Be careful on wet or icy surfaces.
• Use a cane, walking stick, or walker if you need to feel steadier when you walk.