Influence of instability and muscular weakness in ethiopathogenesis of hip fractures

The aim of our study was to, in accordance with the presented theoretical presumptions, analyze the possible reasons for hip fractures of the older population in the north-eastern part of Croatia. A group of 2,696 persons (1,936 women and 760 men) with hip fractures has been analyzed during a 12 year period (from 1993. until 2005. year) in the Clinical Hospital Osijek. The date of admittance, age, gender and fracture location were recorded. In men, the incidence of total hip fracture number on the left side was greater 23.5% (p<0.01) compared to the right side, while in women this difference does not exist. Men have a greater incidence of trochanteric fractures than fractures of femoral neck on both sides, while in women this difference could be shown on the right side only. In women, a 30.5% (p<0.001) higher fracture incidence occurred in the winter compared to the summer. It has been concluded that in men the impaired neuromuscular function on the left body side caused the greater incidence of falls on this side. The more frequent multifragmental fractures of the trochanteric massive in men indicate the possible role of preserved pelvitrochanteric muscle tension in fracture characterization. Increased incidence of falls and fractures in the older female population can be interpreted with a more pronounced weakness of pelvitrochanteric muscles and consequent walking instability. Furthermore, a smaller incidence of hip fractures was noticed in the summer compared with winter. This is explained by a reduced exhaustion of pelvic muscles in summer (primarily pelvitrochanteric) and decrease in fall frequency.