PETALING JAYA: With the ageing population increasing in the country, so are hip fractures caused by falls.
According to a study, such injuries are projected to increase by 3.5-fold in just over two decades, up from about 6,000 cases to nearly 21,000 in 2050, the highest among the nine Asian countries surveyed by the Asian Federation of Osteoporosis Societies.
It said Malaysia’s rapidly ageing population places mounting pressure on an already stretched healthcare system.
The projected surge is expected to cost more than US$125mil (RM507.4mil) annually.
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Singapore is expected to see the second-largest increase in hip fractures, rising 3.53-fold from 4,477 to 15,806, followed by Hong Kong (2.86-fold) and South Korea (2.85-fold).
“The main target in Asia is to reduce the annual incidence of hip fracture by 2% to 3% each year to stabilise the total number of hip fractures over time.
“To achieve this goal, it is essential for various stakeholders – including patients, their families, healthcare professionals and government bodies – to be actively engaged,” it was emphasised.
Another study by the Malaysian Orthopaedic Journal, “The Current and Future Challenges of Hip Fracture Management in Malaysia”, said strengthening acute fracture care, expanding rehabilitation and secondary prevention services, and recognising musculoskeletal health as a national priority are essential steps to mitigate the looming impact of hip fractures in the decades ahead.
It said that falls were the most common cause of hip fractures, with most individuals sustaining a deterioration in mobility and becoming more dependent for daily living, which would persist six to 12 months post-fracture.
“Several risk factors were associated with inpatient mortality, such as increasing age, hearing impairment, visual impairment, chronic kidney disease, thyroid disease and an abbreviated mental test of less than eight.
“Those not operated were 2.6 times more likely to die compared to those operated,” it said.
The study noted that many patients did not receive comprehensive fall assessments, rehabilitation planning or osteoporosis treatment after discharge, leaving them at a high risk of sustaining a second fracture.
In terms of fracture type, femoral neck fractures (breaks in the narrow section of the thigh bone or femur) accounted for between 23% and 62% of cases, while intertrochanteric fractures (breaks in the upper part of the thigh bone or femur) made up about 46%.
The study said Malaysians who sustained hip fractures shared similar characteristics with those reported internationally – they were older, medically complex and at a high risk of falling.
“The average age of hip fracture patients in Malaysia ranges from 74 to 79 years, and up to three-quarters are women.
“About 77% have at least one chronic medical condition, while around one in four are multimorbid,” it said.
It added that diabetes is among the most common comorbidities, affecting 25% to 46% of patients, followed by hypertension (34%–74%), ischaemic heart disease (3%–11%) and stroke (6%–10%).
“A significant proportion already had a history of falls or fractures before their injury, with one in four reporting a previous fall, 13% a prior fragility fracture, and 5% a previous hip fracture,” it said.
Despite their high fracture risk, the study noted that only 12% were taking medication or supplements to support bone health, such as anti-osteoporosis drugs, calcium or vitamin D.
