{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:14:27Z","timestamp":1788351267110,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011930","name":"Beijing Medical and Health Foundation","doi-asserted-by":"publisher","award":["B20664FN"],"award-info":[{"award-number":["B20664FN"]}],"id":[{"id":"10.13039\/501100011930","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to identify which of the risk factors would contribute to the contralateral fracture in very elderly patients after intramedullary nail fixation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data of 227 intertrochanteric fracture patients aged 80 years or older were retrospectively reviewed. Intramedullary nails (IMNs) were used on all of the patients. Potential risk factors for contralateral hip refractures were determined using univariate and logistic regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Contralateral hip refractures occurred in 11 patients (4.84%). Univariate analysis revealed that age, gender, body mass index, fracture classification, hematocrit, D-dimer, and CRP level were not associated with contralateral fractures (<jats:italic>P\u2009<\/jats:italic>&amp;gt;\u20090.05). However, neurological diseases, cardiovascular disease, and visual impairments were significantly associated with contralateral fractures (<jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.05). Multivariate analysis further revealed that neurological diseases (OR 4.25, <jats:italic>P\u2009<\/jats:italic>=\u20090.044) and visual impairments (OR 5.42, <jats:italic>P\u2009<\/jats:italic>=\u20090.015) were independent risk factors associated with contralateral refractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To prevent contralateral refractures, more attention should be paid to elderly intertrochanteric fracture patients with underlying neurological disease and visual impairments.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.924585","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T05:43:47Z","timestamp":1663047827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors for contralateral hip refractures in patients aged over 80 years with intertrochanteric femoral fractures"],"prefix":"10.3389","volume":"9","author":[{"given":"Shujun","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiao","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiacheng","family":"Zang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanzhe","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinguang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s00391-018-1382-z","article-title":"Epidemiology of hip fractures","volume":"52","author":"Rapp","year":"2019","journal-title":"Z Gerontol Geriat"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1093\/ageing\/afab031","article-title":"Mortality in hip fracture patients after implementation of a nurse practitioner-led orthogeriatric care program: results of a 1-year follow-up","volume":"50","author":"van Leendert","year":"2021","journal-title":"Age Ageing"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1016\/j.injury.2013.03.034","article-title":"Risk factors for contra-lateral hip fracture in elderly patients with previous hip fracture","volume":"44","author":"Chang","year":"2013","journal-title":"Injury"},{"key":"B4","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.afos.2020.05.004","article-title":"Second hip fracture in Hong Kong - incidence, demographics, and mortality","volume":"6","author":"Ho","year":"2020","journal-title":"Osteoporos Sarcopenia"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1001\/archinte.167.18.1971","article-title":"Second hip fracture in older men and women: the framingham study","volume":"167","author":"Berry","year":"2007","journal-title":"Arch Intern Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1007\/s00198-002-1327-6","article-title":"Incidence and risk factors for a second hip fracture in elderly women. The study of osteoporotic fractures","volume":"14","author":"Chapurlat","year":"2003","journal-title":"Osteoporos Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1016\/j.injury.2014.05.030","article-title":"Patient characteristics and risk of subsequent contralateral hip fracture after surgical management of first fracture","volume":"45","author":"Lau","year":"2014","journal-title":"Injury"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1007\/s00068-018-0981-0","article-title":"Comparative analysis of non-simultaneous bilateral fractures of the proximal femur","volume":"45","author":"M\u00fcller","year":"2019","journal-title":"Eur J Trauma Emerg Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1302\/0301-620X.94B1.27983","article-title":"Characteristics and outcome in patients sustaining a second contralateral fracture of the hip","volume":"94","author":"Sawalha","year":"2012","journal-title":"J Bone Joint Surg Br"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1007\/s00198-015-3104-3","article-title":"Excess mortality associated with second hip fracture","volume":"26","author":"Sobolev","year":"2015","journal-title":"Osteoporos Int"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000233","article-title":"Complications and institutionalization are almost doubled after second hip fracture surgery in the elderly patient","volume":"29","author":"van der Steenhoven","year":"2015","journal-title":"J Orthop Trauma"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.archger.2014.02.012","article-title":"Meta-analysis of risk factors for the second hip fracture (SHF) in elderly patients","volume":"59","author":"Zhu","year":"2014","journal-title":"Arch Gerontol Geriatr"},{"key":"B13","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1177\/0269215514542358","article-title":"Risk factors for the second contralateral hip fracture in elderly patients: a systematic review and meta-analysis","volume":"29","author":"Liu","year":"2015","journal-title":"Clin Rehabil"},{"key":"B14","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1038\/s41440-020-0435-z","article-title":"Vascular function is further impaired in subjects aged 80 years or older","volume":"43","author":"Maruhashi","year":"2020","journal-title":"Hypertens Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"193","DOI":"10.3944\/AOTT.2009.193","article-title":"Major risk factors for the second contralateral hip fracture in the elderly","volume":"43","author":"Angthong","year":"2009","journal-title":"Acta Orthop Traumatol Turc"},{"key":"B16","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1093\/oxfordjournals.aje.a008800","article-title":"Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly","volume":"143","author":"Karagas","year":"1996","journal-title":"Am J Epidemiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"647","DOI":"10.3109\/17453679308994590","article-title":"Effect of sex and age on the ratio of cervical to trochanteric hip fracture. A meta-analysis of 16 reports on 36,451 cases","volume":"64","author":"Baudoin","year":"1993","journal-title":"Acta Orthop Scand"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3647","DOI":"10.1007\/s11999-015-4469-5","article-title":"Which fixation device is preferred for surgical treatment of intertrochanteric hip fractures in the United States? A survey of orthopaedic surgeons","volume":"473","author":"Niu","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1097\/00005131-200310000-00003","article-title":"The second hip fracture\u2013an analysis of 84 elderly patients","volume":"17","author":"Shabat","year":"2003","journal-title":"J Orthop Trauma"},{"key":"B20","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1007\/s002239900446","article-title":"Possible predisposing factors for the second hip fracture","volume":"62","author":"Dretakis","year":"1998","journal-title":"Calcif Tissue Int"},{"key":"B21","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1016\/j.jos.2018.12.029","article-title":"Clinical characteristics of osteoporotic second hip fracture: from the data of clinical pathway with regional alliance in rural region in Japan","volume":"24","author":"Yoshii","year":"2019","journal-title":"J Orthop Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"418","DOI":"10.2106\/JBJS.J.01134","article-title":"The rate of contralateral proximal femoral fracture following closed reduction and percutaneous pinning compared with arthroplasty for the treatment of femoral neck fractures","volume":"94","author":"Souder","year":"2012","journal-title":"J Bone Joint Surg Am"},{"key":"B23","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1097\/01.ta.0000241143.71274.63","article-title":"Femoral neck shortening after fracture fixation with multiple cancellous screws: incidence and effect on function","volume":"64","author":"Zlowodzki","year":"2008","journal-title":"J Trauma"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1016\/j.injury.2016.03.009","article-title":"Proximal femoral nail shows better concordance of gait analysis between operated and uninjured limbs compared to hemiarthroplasty in intertrochanteric femoral fractures","volume":"47","author":"G\u00fcven","year":"2016","journal-title":"Injury"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2309499017727943","DOI":"10.1177\/2309499017727943","article-title":"Decreased postoperative gluteus medius muscle cross-sectional area measured by computed tomography scan in patients with intertrochanteric fractures nailing","volume":"25","author":"Noda","year":"2017","journal-title":"J Orthop Surg"},{"key":"B26","first-page":"1","article-title":"Orthopaedic Trauma Association Committee for Coding and Classification","year":"1996","journal-title":"J Orthop Trauma"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200711101-00001","article-title":"Fracture and dislocation classification compendium 2007: Orthopaedic Trauma Association classification, database and outcomes committee","volume":"21","author":"Marsh","year":"2007","journal-title":"J Orthop Trauma"},{"key":"B28","doi-asserted-by":"publisher","first-page":"147","DOI":"10.33160\/yam.2021.05.001","article-title":"Current and future burden of hip and vertebral fractures in Asia","volume":"64","author":"Hagino","year":"2021","journal-title":"Yonago Acta Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s00223-017-0364-2","article-title":"Second hip fracture: incidence, trends, and predictors","volume":"102","author":"Mazzucchelli","year":"2018","journal-title":"Calcif Tissue Int"},{"key":"B30","doi-asserted-by":"publisher","first-page":"571","DOI":"10.3928\/0147-7447-20010601-14","article-title":"Incidence of bilateral proximal femoral fractures in a tertiary care center","volume":"24","author":"Kaper","year":"2001","journal-title":"Orthopedics"},{"key":"B31","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.otsr.2010.07.011","article-title":"Non-simultaneous bilateral hip fracture: epidemiologic study of 241 hip fractures","volume":"97","author":"Gaumetou","year":"2011","journal-title":"Orthop Traumatol Surg Res"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1007\/s00198-005-1835-2","article-title":"Assessment of risk factors for second hip fractures in Japanese elderly","volume":"16","author":"Yamanashi","year":"2005","journal-title":"Osteoporos Int"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1007\/s00198-007-0375-3","article-title":"Incidence of second hip fractures. A population-based study","volume":"18","author":"L\u00f6nnroos","year":"2007","journal-title":"Osteoporos Int"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1007\/s00402-012-1520-9","article-title":"Contralateral hip fractures and other osteoporosis-related fractures in hip fracture patients: incidence and risk factors. An observational cohort study of 1,229 patients","volume":"132","author":"Vochteloo","year":"2012","journal-title":"Arch Orthop Trauma Surg"},{"key":"B35","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1302\/0301-620X.92B2.23108","article-title":"Age-specific incidence of first and second fractures of the hip","volume":"92","author":"Lawrence","year":"2010","journal-title":"J Bone Joint Surg Br"},{"key":"B36","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1259\/bjr\/37401526","article-title":"Bone density and geometry in assessing hip fracture risk in post-menopausal women","volume":"80","author":"Gnudi","year":"2007","journal-title":"Br J Radiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.21037\/apm-20-855","article-title":"Correlation between C-reactive protein\/albumin and contralateral hip refracture after total hip arthroplasty in elderly patients with hip fractures","volume":"9","author":"Chen","year":"2020","journal-title":"Ann Palliat Med"},{"key":"B38","doi-asserted-by":"publisher","first-page":"146","DOI":"10.5606\/ehc.2016.30","article-title":"Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database","volume":"27","author":"Juh\u00e1sz","year":"2016","journal-title":"Eklem Hastalik Cerrahisi"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e5152","DOI":"10.1097\/MD.0000000000005152","article-title":"C-reactive protein is an independent predictor for 1-year mortality in elderly patients undergoing hip fracture surgery: a retrospective analysis","volume":"95","author":"Kim","year":"2016","journal-title":"Medicine"},{"key":"B40","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1002\/jbmr.2037","article-title":"High-sensitivity CRP is an independent risk factor for all fractures and vertebral fractures in elderly men: the MrOS Sweden study","volume":"29","author":"Eriksson","year":"2014","journal-title":"J Bone Miner Res"},{"key":"B41","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s00776-006-1056-3","article-title":"Bilateral hip fractures","volume":"11","author":"Fukushima","year":"2006","journal-title":"J Orthop Sci"},{"key":"B42","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1007\/s00198-012-2250-0","article-title":"Incidence of second hip fracture and compliant use of bisphosphonate","volume":"24","author":"Lee","year":"2013","journal-title":"Osteoporos Int"},{"key":"B43","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s00776-009-1440-x","article-title":"Risk factors for second hip fractures among elderly patients","volume":"15","author":"Mitani","year":"2010","journal-title":"J Orthop Sci"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.924585\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T05:43:51Z","timestamp":1663047831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.924585\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,13]]},"references-count":43,"alternative-id":["10.3389\/fsurg.2022.924585"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.924585","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,13]]},"article-number":"924585"}}