Femoral Intertrochanteric Fractures of the Patients in the Emergency Department due to Minor Falls: Special Consideration in the Middle-old to Oldest-old Patients

BACKGROUND: The older population (≥65 years) has rapidly increased in size in recent years. Among them, the middle-to-oldest-old (≥75 years) tend to have a poor health status. Therefore, subdivision and evaluation of older patients with traumatic injury are required. We focused on the risk of femoral intertrochanteric fractures occurring in older adults due to minor falls and compared young-old and middle-to-oldest-old populations. METHODS: The medical records of patients who visited the emergency center due to hip injuries between March 2017 and March 2019 were retrospectively analyzed. Patients were divided into older adult (≥65 years) and non-older (age 18–64 years) groups; the older adult group was subdivided into young-old (65–74 years), middle-old (75–84 years), and oldest-old (≥85 years) groups. This study investigated the occurrence rate of femoral intertrochanteric fractures and related factors. RESULTS: The older adult group had a higher incidence of femoral intertrochanteric fractures than that in the non-older adult group (95.3% vs. 4.7%, p<0.001). However, there was no significant difference between young-old and non-older groups (58.8% vs. 41.2%, p=0.145). Middle-old to oldest-old age and osteoporosis were associated with an increased incidence of femoral intertrochanteric fractures (p<0.001, p=0.004). CONCLUSION: A higher incidence of femoral intertrochanteric fractures from minor falls was found among middle-old to oldest-old patients compared to that in young-old patients. Therefore, physicians should perform more thorough physical examinations and radiograph reading in middle-old to oldest-old patients even if the patients do not complain of pain.