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Do non-simultaneous bilateral proximal femoral fractures in the elderly have a similar pattern?
Umberto Lavagnolo, Tommaso Maluta, Lorenzo Marcucci, Matteo De Marchi, Enrico Salvatore D’Agostino, Eugenio Vecchini, Bruno Magnan, Elena Manuela Samaila, Orthopedics and Traumatology Unit, Department of Surgery and Dentistry, Azienda Ospedaliera Universitaria Integrata, University Hospital of Verona, Verona 37126, Veneto, Italy
Author contributions: Lavagnolo U and Maluta T conceived and conducted the study and wrote the manuscript; De Marchi M and D’Agostino ES collected the data; Lavagnolo U processed the database and performed the statistical analyses; Vecchini E, Samaila EM, and Magnan B revised the work, contributing to conceiving, refining the study design and the writing of the manuscript.
Institutional review board statement: In consideration of the retrospective analysis, the Local Research Ethics Committee has confirmed that no ethical approval is required.
Informed consent statement: All patients signed informed consent to be enrolled in the study.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The data supporting the findings of this study are owned by the University of Verona and are available upon reasonable request.
Corresponding author: Umberto Lavagnolo, MD, Orthopedics and Traumatology Unit, Department of Surgery and Dentistry, Azienda Ospedaliera Universitaria Integrata, University Hospital of Verona, Piazzale Aristide Stefani 1, Verona 37126, Veneto, Italy.
Received: February 7, 2026
Revised: March 8, 2026
Accepted: May 25, 2026
Published online: July 18, 2026
Processing time: 154 Days and 7.7 Hours
Revised: March 8, 2026
Accepted: May 25, 2026
Published online: July 18, 2026
Processing time: 154 Days and 7.7 Hours
Core Tip
Core Tip: This retrospective study shows that approximately one in ten elderly patients sustaining a proximal femoral fracture (PFF) will later experience a contralateral fracture. The second fracture frequently reproduces the same fracture pattern as the first, and multivariate analysis confirms that the initial fracture type is an independent predictor of the contralateral fracture pattern. Most second fractures occur within a 2-5 years interval after the first event. These findings suggest that patients with a first PFF represent a clearly identifiable high-risk population in whom targeted secondary prevention strategies should be prioritized.