Bone & Joint Open · IF 2.8 · August 13, 2026 · LoE III
Fracture laterality as an independent prognostic factor for clinical outcomes after hip fracture surgery
Yasuhiko Takegami, Takahiro Imaizumi, Kikue Sato, Yusuke Osawa, Hiroto Funahashi, Shiro Imagama — Nagoya University
This Japanese administrative-database study followed 72,008 patients age 65+ who had surgery for hip fracture, asking whether the side of the fracture (left vs right) predicts outcomes. Overall in-hospital mortality did not differ significantly by side (adjusted OR 1.10, 95% CI 0.99-1.22, p=0.075), but right-sided fractures were associated with slightly worse independence at discharge (Barthel Index <60; adjusted OR 1.09, 95% CI 1.05-1.13, p<0.001), and among patients with high comorbidity burden (CCI \u2265 2), right-sided fracture carried a higher mortality risk (aOR 1.29, 95% CI 1.09-1.53).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersFracture laterality is a free, already-recorded data point that could add modest prognostic information for discharge planning and rehabilitation intensity in frail hip fracture patients, if the association is confirmed prospectively.
Conclusion strengthInconclusive
The conclusion asserts a benefit the primary outcome did not show.
Presenting this at rounds? Start here
- ?If confirmed, should right-sided hip fracture prompt earlier or more intensive physical therapy referral at discharge planning?
- ?In patients with high comorbidity burden and a right-sided hip fracture, should clinicians have a lower threshold for escalating perioperative monitoring given the observed mortality signal?