The impact of hip fracture on patients with history of fragility fracture

Introduction Hip fracture causes patient significant comorbidities. The history of previous fragility fracture (PFF) might have alarmed clinicians on the imminent fracture risk before the hip fracture occurs. This study is to review the impact of hip fracture on the mobility status in patients with or without history of PFF. Methods All hip fracture patients, who were admitted to a regional hospital from July 2022 to June 2024, were recruited. Their demographics data, pre-injury and post-injury 1-year mobility status, 1-year mortality, rates of bone density scan (DXA), and prescription of bone health medication (BHM) were retrieved from clinical record. Results 336 patients were included. 108 (32.1%) patients were found with history of PFF and 26 (24.1%) of them were having their second hip fracture. All patients, whether with or without history of PFF, suffered from a significant decline in mobility. However, patients without a history of previous fragility fracture (NFF) have better pre-injury ( p = 0.010) and post-injury mobility status ( p = 0.027). The patients having the second hip fracture (PHF group), despite having better pre-injury mobility status ( p = 0.015), had comparable post-injury mobility with the patients without history of previous hip fracture (NHF group) ( p = 0.157). 1-year mortality for NFF was higher when comparing to PFF (15.4% vs 9.26%), yet the figure was insignificant ( p = 0.139). Reviewing PFF cohort, 30 (27.8%) patients suffered from fragility fracture within 2 years before this episode of injury. 21 (19.4%) patients had history of recurrent fall which required admission. DXA was done and BHM was started in only 18 and 13 patients, respectively. Discussion and conclusion Hip fracture causes marked decline in patients’ mobility. Early and structured intervention should be taken for previous episodes of fragility fracture as they alarm the possible upcoming hip fracture, which could cause devastating outcome in terms of functional morbidity and mortality.