{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T21:44:00Z","timestamp":1781127840730,"version":"3.54.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Oulu including Oulu University Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>The life-time risk of a second fragile hip fracture is 8.4%, but the risk factors that predispose to a second hip fracture remain unresolved. This study aimed to define risk factors that predisposed patients to a second hip fracture.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>For this retrospective study, we retrieved clinical data on 1130 patients with fragile hip fractures (67.2% female, mean age: 79.3\u00a0years) that underwent surgery at the Oulu University Hospital in 2013\u20132016. These data included the fracture risk assessment score (measured with the FRAX tool), the bone-mass <jats:italic>T<\/jats:italic>-score, laboratory values, ambulatory capacity, and the time of death.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In this population, 12.4% of patients sustained a second hip fracture. The predisposing factors for a second hip fracture were: female (<jats:italic>p<\/jats:italic>\u2009=\u20090.016), a high FRAX score (<jats:italic>p<\/jats:italic>\u2009=\u20090.020), and low physical capacity (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The vitamin D level recommended for treating osteoporosis (i.e., vitamin D\u2009&gt;\u200975\u00a0nmol\/l) was observed in only 24% of patients, and 42% of patients had ionized calcium levels below the reference range. According to the level of the cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), 37% of patients did not have high bone turnover. We found a positive correlation between age and ICTP (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The risk of death was higher after the second hip fracture (<jats:italic>p<\/jats:italic>\u2009=\u20090.005), but we found no difference in age between patients with first and second hip fractures (<jats:italic>p<\/jats:italic>\u2009=\u20090.11).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>After a hip fracture, a second hip fracture is a well-known risk. Nevertheless, we found that only one-third of patients with a second hip fracture had used anti-osteoporosis medication at any time previously. These findings suggested that second hip fractures were most likely to occur in patients with osteopenic <jats:italic>T<\/jats:italic>-score values, in women more often than men, and in patients with high FRAX scores and low ambulatory capacity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-022-04406-4","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T06:02:53Z","timestamp":1647324173000},"page":"2261-2271","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predisposing factors for a second fragile hip fracture in a population of 1130 patients with hip fractures, treated at Oulu University Hospital in 2013\u20132016: a retrospective study"],"prefix":"10.1007","volume":"143","author":[{"given":"Nelli","family":"Helynen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotta","family":"Rantanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petri","family":"Lehenkari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarit","family":"Valkealahti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"key":"4406_CR1","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","volume":"8","author":"E Hernlund","year":"2013","unstructured":"Hernlund E, Svedbom A, Iverg\u00e5rd M, Compston J, Cooper C, Stenmark J et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. 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