Studies over the last few decades have demonstrated geographic variation in the incidence of hip fracture across continents as well as among different parts of a region. 1 With rising life expectancy throughout the globe, the number of elderly individuals is increasing in every geographical region, and it is estimated that the incidence of hip fracture will rise from 1.66 million in 1990 to 6.26 million by 2050. Osteoporotic hip fracture is an established health problem in the West and is increasingly recognized as a growing problem in Asia as per the Asian Audit Report, 2009. Hip fracture has been recognized as the most serious consequence of osteoporosis because of its complications, which include chronic pain, disability, diminished quality of life, and premature death. Osteoporosis represents a major public health problem because of its association with low-energy trauma or fragility fractures.
The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates) and the influence of ethnicity, latitude, and environmental factors. There is also a north–south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation.
The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. Hip fracture contributes to both morbidity and mortality in the elderly.
Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist.
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