The Journal of Bone and Joint Surgery, Vol 77, Issue 5 695-702, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Relative rates of fracture of the hip in the United States. Geographic, sex, and age variations
RY Hinton, DW Lennox, FR Ebert, SJ Jacobsen and GS Smith
Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland 21218, USA.
We studied the Medicare data from 1984 through 1987 for 687,850 fractures
of the hip that had occurred in the United States. Our purpose was to
determine the geographic, sex-specific, and age-interval variations in the
relative risk of fracture of the hip in elderly white individuals. The
rates of cervical, trochanteric, and subtrochanteric fracture, and the
over-all rate of fracture at any of the three levels, increased with age,
were greater for women than for men, and were higher in the Southern part
of the country. However, there were regional, sex, and age variations. The
ratio of cervical to trochanteric fractures was significantly higher in the
East South Central region and lower in the Middle Atlantic and New England
regions (p < 0.05). These were the same areas with the highest and
lowest over-all rates, respectively, of fracture of the hip. The ratio of
cervical to trochanteric fractures decreased from 1.52 in women who were
sixty-five to sixty-nine years old to 0.81 in women who were at least
eighty-five years old, but it stayed at approximately 1.00 for the
corresponding age-groups of men. The ratio of fracture of the hip in women
to fracture of the hip in men varied depending on the level of the
fracture.
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