{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:11:27Z","timestamp":1777677087922,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008247","name":"university of otago","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The purpose of this study was to determine whether there have been changes in the numbers and complexity of femoral fragility fractures presenting to our department over a period of 10\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients &gt;60\u2009years presenting with femoral fragility fractures to our institution in 2018\u20132019 (397 fractures) were compared with respect to demographic data, incidence rates, fracture classification and surgical management with a historical cohort from 2009\u20132010 (335 fractures). Pathological and high velocity fractures were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The gender proportion and average age (83.1 vs. 82.7\u2009years) was unchanged. The number of femoral fractures increased by 19% but the overall incidence in people &gt;60\u2009years fell by 6% ( p\u2009 =\u20090.41). The proportion of unstable trochanteric fractures (31A2 and A3) increased from 22% to 55% ( p\u2009 &lt;\u20090.001). The proportion of displaced intracapsular fractures increased from 53% to 72% ( p\u2009 &lt;\u20090.001). The incidence of stable trochanteric fractures fell from 12.4 to 7.3\/10,000 patients&gt;60\u2009years ( p\u2009=\u20090.0006) while the incidence of unstable trochanteric fractures (31A2 and 31A3) increased from 3.5 to 8.9\/10,000 patients &gt;60\u2009years ( p\u2009&lt;\u20090.0001). The proportion of trochanteric fractures treated with an intramedullary (IM) nail increased from 9% to 35% ( p\u2009=\u20090.0001). The number of shaft and distal femoral fractures increased by 41% although the incidence did not change significantly. Periprosthetic fractures comprised 70% of femoral shaft fractures in both cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The increasing number and complexity of femoral fragility fractures, especially unstable trochanteric fractures and periprosthetic fractures, is likely to have an impact on implant use, theatre time and cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000231199073","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T01:30:40Z","timestamp":1696296640000},"page":"252-259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The increasing complexity of femoral fragility fractures: incidence, fracture patterns and management over a 10-year period"],"prefix":"10.1177","volume":"34","author":[{"given":"Alexandria","family":"Gibson","sequence":"first","affiliation":[{"name":"Dunedin Hospital, Dunedin, Otago, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Guest","sequence":"additional","affiliation":[{"name":"Dunedin Hospital, Dunedin, Otago, New Zealand"},{"name":"Dunedin School of Medicine, Orthopaedic Surgery, University of Otago, Dunedin, Otago, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1593-3842","authenticated-orcid":false,"given":"Trenton","family":"Taylor","sequence":"additional","affiliation":[{"name":"Dunedin Hospital, Dunedin, Otago, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fraser","family":"Harrold","sequence":"additional","affiliation":[{"name":"Dunedin Hospital, Dunedin, Otago, New Zealand"},{"name":"Dunedin School of Medicine, Orthopaedic Surgery, University of Otago, Dunedin, Otago, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8484-614X","authenticated-orcid":false,"given":"David","family":"Gwynne Jones","sequence":"additional","affiliation":[{"name":"Dunedin Hospital, Dunedin, Otago, New Zealand"},{"name":"Dunedin School of Medicine, Orthopaedic Surgery, University of Otago, Dunedin, Otago, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"bibr1-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2016.06.007"},{"key":"bibr2-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-0962-6"},{"key":"bibr3-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2018.04.008"},{"key":"bibr4-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1462"},{"key":"bibr5-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-017-0341-4"},{"key":"bibr6-11207000231199073","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-4345-0"},{"key":"bibr7-11207000231199073","unstructured":"Australian New Zealand Hip Fracture Registry. 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