Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 10;18(1):491.
doi: 10.1186/s13018-023-03981-5.

The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study

Yannick Rau  1   2 , Jasper Amtsfeld  3 , Nils Reimers  4   5 , Ludwig Matrisch  6 , Jasper Frese  7   8 , Arndt-Peter Schulz  6   7   8
Affiliations

The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study

Yannick Rau et al. J Orthop Surg Res. .

Abstract

Background: Hip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments.

Methods: Data were retrieved from the national database of the German Department of the Interior. ICD-10-GM and OPS data from the period of 2006 to 2020 were analysed and all patients with trochanteric and subtrochanteric fractures as their main diagnosis, who were treated in a German hospital, were included. Patients were grouped by age and gender and linear regression was performed where suitable to calculate statistically significant correlations between variables and incidences.

Results: 985,104 pertrochanteric fractures and 178,810 subtrochanteric fractures were reported during the analysed period. We calculated a mean incidence of 80.08 ± 6.34 for pertrochanteric and 14.53 ± 1.50 for subtrochanteric fractures per million inhabitants. In both fracture types, a distinct dependence of incidence on age can be determined. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under the age of 60 to those over the age of 90 in pertrochanteric fractures, and about 123-fold in subtrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Plate and dynamic compression screws were decreasing in frequency over the analysed period in both fractures.

Conclusions: We provided incidence data on per- and subtrochanteric fractures and their treatment. We calculated an economic impact of approximately 1.563 billion € per year in Germany. With regards to recent literature on costs of treatment and our findings regarding the implementation and utilization of different treatment methods, we conclude that the reinforcement of nationwide prevention programs is a relevant step in lessening the economic burden. We welcome the increased utilisation of intramedullary nailing as many studies show beneficiary outcomes and cost effectiveness in most of the included fracture types.

Keywords: Epidemiology; Incidence; Osteosynthesis; Trauma; Trochanteric fractures.

PubMed Disclaimer

Conflict of interest statement

There are no competing interests present.

Figures

Fig. 1
Fig. 1
a Incidence development of pertrochanteric fractures. b Incidence development of subtrochanteric fractures
Fig. 2
Fig. 2
a Procedures performed on pertrochanteric fractures. b Procedures performed on subtrochanteric fractures
Fig. 3
Fig. 3
a Standardised procedures prevalence on pertrochanteric fractures. b Standardised procedures prevalence on subtrochanteric fractures
Fig. 4
Fig. 4
a Prevalence of cerclages in both fracture type. b Standardised prevalence of cerclages in both fracture types
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Wu AM, Bisignano C, James SL, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580–e592. doi: 10.1016/S2666-7568(21)00172-0. - DOI - PMC - PubMed
    1. Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B. Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int. 2011;22(10):2575–2586. doi: 10.1007/s00198-011-1596-z. - DOI - PubMed
    1. Bertram M, Norman R, Kemp L, Vos T. Review of the long-term disability associated with hip fractures. Inj Prev. 2011;17(6):365–370. doi: 10.1136/ip.2010.029579. - DOI - PubMed
    1. Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskelet Disord. 2018;19:369. doi: 10.1186/s12891-018-2276-3. - DOI - PMC - PubMed
    1. WHO. World population prospects 2019. PD Department of Economic and Social Affairs, Editor. Published online 2019