Epidemiology of femur fracture in adults at King Abdulaziz Medical City from 2020 to 2024: a cross-sectional study

Objective: This study aimed to determine the epidemiology, common sites, and demographic patterns of femur fractures among adults at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Methods: This cross-sectional study analyzed data from 6,148 adult patients (≥18 years) with confirmed femur fractures treated between January 2020 and September 2024. Patient information was extracted from electronic medical records (BESTCare system) using a consecutive sampling technique. Data included demographic characteristics, fracture sites, and relevant comorbidities [body mass index (BMI), vitamin D deficiency, thyroid disorders, and osteoporosis]. Results: Of the 6,148 patients, 58.0% were male (n = 3,358). Proximal femur fractures were most prevalent (43.4%, n = 2,685), followed by unspecified fractures (23.7%, n = 1,465). The highest incidence occurred in patients above 75 years (30.2%, n = 1,865), followed by those aged 60-74 years (25.4%, n = 1,568). Gender differences were statistically significant (p < 0.001), with proximal femur fractures more common in males (54.8%) and distal femur fractures in females (59.4%). Significant associations were found between fracture location and BMI categories (p-value = 0.0001), vitamin D deficiency (p-value = 0.0001), hyperthyroidism (p-value = 0.005), and osteoporosis (p-value = 0.0001), with the latter most prevalent in distal femur fractures (24.71%) and proximal femur fractures (22.46%). Conclusion: This comprehensive analysis of femur fractures in a Saudi Arabian medical center demonstrated distinct patterns in fracture epidemiology related to age, gender, and comorbidities. The findings highlighted the importance of targeted preventive strategies, particularly for elderly populations and those with metabolic bone disorders, to reduce fracture incidence and associated morbidity and mortality.