Background: This study was done to know whether patients with hip injury have pre-existing osteoporosis due to which, the patient sustained the fracture, subsequent fracture of the contralateral hip, any osteoarthritic changes of the contralateral hip at the time of index fracture, and ten-year probability of a major osteoporotic fracture by calculating fracture risk assessment percentage (FRAX%). Methods: 34 patients were evaluated for age, gender, body mass index (BMI), fracture type, Singh index, bone mineral density (BMD), T-scores using dual-energy X-ray absorptiometry (DEXA) scan, and ten-year probability of fracture using FRAX%. Results: Average age of the patients with hip fractures was 72. 1 years. About 85% of patients were women. 67. 6% of the patients were with BMI of 18. 5-25 kg/m2. The Singh index for osteoporosis fell in grades 2 and 3 in most patients. The mean interval between index fracture and contralateral hip injury was 4. 25 years. Osteoarthritis of the contralateral hip was seen in 9%. The probability in ten years of hip fracture in 30 indexed patients using the FRAX% tool was 15%, and for 4 patients who were having bilateral hip fractures was 22. 75%. There was a significant relationship between FRAX% with the Singh index and osteoarthritis of the contralateral hip. FRAX% was high in female patients. Conclusion: Contralateral hip fracture in patients with osteoporosis was high in women and patients with low and high BMI. Fractures were also high in patients with low Singh index and T-scores. FRAX% increased with an increase in age and increased with a decrease in T-score.

Background: Blind individuals are more prone to falls and subsequent proximal femoral fractures. While hip hemiarthroplasty is a common treatment option for displaced femoral neck fractures in the elderly, evidence regarding the outcomes of hip hemiarthroplasty in blind individuals is still lacking.Objectives: This retrospective study aimed to evaluate the clinical and radiographic outcomes among a series of blind patients who received hip hemiarthroplasty for femoral neck fractures.Methods: Fifteen patients (15 cases, 11 females) with a mean age of 79.7 years (range, 59-100) at the time of surgery were included in this study. Seven patients were bilaterally blind, while eight patients had unilateral blindness. All of the patients received hip hemiarthroplasty (10 received bipolar and 5 unipolar hemiarthroplasty) for displaced femoral neck or proximal femoral fractures.Results: The mean follow-up for all patients is 49 months. At their last follow-up visits, fourteen cases were able to bear weight fully with or without assistive devices while one patient was wheelchair-bound. The mean calculated pre-injury, and last follow-up postoperative Parker Mobility Index for all patients were 4.7 and 4.5, respectively (p=.8). Three patients (20%) had subsequent, recurrent falls that resulted in other skeletal fractures without hemiarthroplasty dislocations or periprosthetic fractures. One patient developed a prosthetic joint infection and was managed with surgical debridement and antibiotic spacer placement.Conclusions: Hip hemiarthroplasty is a practical treatment option for elderly blind individuals who suffer from displaced femoral neck fractures with overall good implant-related outcomes. Patients should be counseled about the incidence of postoperative recurrent falls and should be instructed to use assistive devices during ambulation.

Background: Hip fracture, the most serious complication of osteoporosis, burdens lots of costs on any health providing system. Previous reports on rates of hip fractures in Asian countries used to differ a lot. The aim of this study was to estimate incidence rate of hip fractures in the city of Shiraz, Iran.Methods: All operating room logs with the diagnosis of hip fracture were reviewed for hip fractures proceeded by a simple falling down in patients over 50 years, between 21st of March 2000 to 21st of March 2003. According to patients medical records, age, sex, type of fracture (intertrochanteric, neck, subtrochantheric) and patients residency regions regarding to Shiraz municipality division were obtained.Results: The age adjusted incidence rates of hip fracture comparing to the United States population records in 1985, (325.74/100000 for men and 519.05/10000 for women) and to the United States population records in 1989 (384.61/100000 for men and 548.17/100000 for women) was the highest in Asia. The intertrochanteric fracture was significantly higher among females (P=0.003). The incidence of intertrochanteric and neck fractures were increased with age. In all the age groups, females had more incidence rates of fractures except of the ages of over 80, in which males had more incidence rates than females.Conclusion: High incidence rate of hip fractures in our population especially in our males of over 80 shows that preventive strategies for hip fractures and osteoporosis should be considered in males as well as females. Further studies are needed to fine this incidence rate in other cities especially city of Tehran.

Background: Osteoporosis is a major public health threat, and hip fracture is a serious consequence of osteoporosis. Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture. The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods: 58 hip fracture patients older than 50yr and BMD £ 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment) which were also followed for 4 years.Results: 72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group. Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6% (p<0.03), respectively.Conclusion: Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

Background: Intetrochanteric hip fracture commonly affects over 70 years old people. While the best acceptable treatment is early fixation, the complication rate is fairly high because of patients' older age and associated age-related comorbidities. We would like to report our experience with the outcome of fixation of such fractures in our locality.Methods: In a descriptive study all the intertrochanteric fractures treated with compression screw-plate system during a 2 year period in two hospitals of Ahwaz were studied.84 patients with mean age of 73.4 (range of 59 to 98 years) were assessed.34 (40.5%) male and 50 (59.5%) female constituted the study group. Patients with a minimum of one year follow-up were evaluated.Results: The complications consisted of 8 (9.5%) varus, 8 (9.5%) shortening, 4 (4.7%) fixation "cut-out", 1 (1.1%) AVN, 13 (15.4%) wound infection and 2 (2.3%) non-union, 9 (10.7%) mortality in 24 weeks.10 (11.9%) underwent reoperation and re-fixation. The average time to returning to pre-fracture activity was 5 months.Conclusion: Complication rate is relatively high in intetrochanteric hip fractures even after screw-plate fixation.Except for high infection rate, in our series, the overall results are similar to the other reports in the literature.