Purpose: The purpose of this study was to evaluate the clinical features and risk factors of sequential bilateral hip fractures in elderly osteoporotic patients.
Materials and Methods: A total of 661 patients who had undergone surgical treatment for osteoporotic hip fractures from April 2001 to June 2011 were retrospectively reviewed. Thirty six patients who had experienced sequential bilateral hip fracture were classified as the BHF group and the rest of the patients were classified as the non-BHF group. Various clinical features, such as T-score of the proximal femur, dwelling pattern, any symptom of dizziness or dementia, health status by ASA classification, BMI, and history of osteoporosis treatment were reviewed and the risk factors of sequential bilateral hip fractures were evaluated.
Results: Mean age of subjects in the BHF group and the non-BHF group was 78.4 years(68-90 years) and 78.0 years(58-99 years), respectively. Mean time interval from initial fracture to second fracture in the BHF group was 29.9 months(2-102 months). No significant differences in T-score of proximal femur (P=0.276), dwelling pattern (P=0.623), dizziness or dementia (P=0.180), health status (P=0.399), and BMI (P=0.629) were observed between the two groups. Eight patients(22.0%) in the BHF group and 254 patients(40.6%) in the non-BHF group were treated with bisphosphonate medications due to osteoporosis during a period of at least one year or more (P=0.028).
Conclusion: Sequential hip fractures in elderly osteoporotic patients over the age of 70 were the result of low energy trauma, and most second fractures occurred within three years from initial injury. A multidisciplinary approach to prevention of a slip and treatment for osteoporosis are considered important to prevention of second hip fractures.

Keywords: Hip fracture, Osteoporosis, Sequential fracture, Bone mineral density