Hip fracture and cancer: descriptive epidemiological study demonstrating a paradigm shift in common orthopedic trauma

Despite the increase both in patients with cancer and those with proximal femoral fractures (PFFs), details of the characteristics of non-pathological PFFs in patients undergoing cancer treatment are unknown. The purpose of this retrospective study was to investigate the characteristics and issues of patients with active cancer who have non-pathological PFFs. This was a retrospective, observational, descriptive epidemiological study. A total of 376 patients were admitted to Juntendo University hospital with a diagnosis of PFF. Six of these patients had metastasis-related pathological fractures and were excluded from this study. The remaining 370 patients comprised 100 men and 270 women. The mean patient age was 78.6 ​± ​11.2 years. Fractures included 141 trochanteric femoral fractures and 229 femoral neck fractures. Of these, 39 (10.5%) of the patients had active cancer, 55 (14.9%) has a history of past cancer, and 276 (74.6%) had no cancer. Among the 39 patients with active cancer, 13 (33.3%) received glucocorticoids; furthermore, 10 (76.9%) of these 13 patients were not receiving medications to prevent osteoporosis. Lastly, 9 of the 39 falls were hospitalization-related, but 6 (66.7%) of these 9 patients did not undergo rehabilitation during hospitalization. Approximately one in ten patients with PFF in this study were undergoing cancer treatment. Moreover, one in four patients with PFF were cancer-related. Therefore, orthopedic surgeons should have basic knowledge about cancer management in hip fracture. • Patients with proximal femoral fractures (PFFs) were investigated. • Characteristics and issues of PFF patients with active cancer were revealed. • Of 370 patients, 39 (10.5%) were undergoing cancer treatment. • Orthopedic surgeons should know about cancer management in hip fracture.