ORIGINAL ARTICLE Hip fracture pattern at a major Tanzanian referral hospital: focus on fragility hip fractures Munyaradzi Tsabasvi 1 & Sonya Davey 2 & Rogers Temu 1 Received: 19 October 2016 /Accepted: 12 April 2017 # International Osteoporosis Foundation and National Osteoporosis Foundation 2017 Abstract Summary This study examined hip fractures during a 5-year period at Kilimanjaro Christian Medical Center (KCMC). There was a general increase in proportions of fragility hip fractures during this period. Purpose Fragility hip fractures are expected to increase in low-resource countries. This study examined hip fractures in the osteoporotic age group during a 5-year period at the Kilimanjaro Christian Medical Center (KCMC), which is lo- cated in Moshi, Tanzania. Methods We conducted a retrospective study of all hip frac- ture patients above the age of 50 who were admitted to KCMC between January 1, 2011 and December 31, 2015. Objective measures including patient demographics, mechanism of injury, and X-ray evaluation were used to differentiate high- and low-energy fractures. Low-energy hip fractures with no other suspected pathological processes on X-ray were labelled as fragility fractures. Results Three hundred forty patients were admitted in the study period and 222 patients met the inclusion criteria. Males contributed to 59.5% of hip fractures. Falls from stand- ing height constituted the majority of fractures (76%) follow- ed by injury from road traffic crashes (14%). Regardless of high- or low-energy aetiology, intertrochanteric fracture dom- inated representing 54.5% of all hip fractures. 75.6% (n = 168) of the analysed patients had fragility fractures. The fragility fractures were 55.8% (n = 96) intertrochanteric, 28.5% (n = 49) cervical, 9.9% (n = 17) subtrochanteric, and 5.8% (n = 10) mixed subtrochanteric with intertrochanteric. We not- ed a 2.34% per year increase in the proportions of fragility fractures among all included hip fractures over 5 years. Conclusion We concluded that men and women contributed almost equally to the fragility hip fracture burden. The domi- nant cause of hip fractures overall was low-energy injuries. There was an increase in proportions of fragility hip fractures in the period of January 2011 to December 2015. Keywords East Africa . Mechanism of injury . Tribe . Fragility hip fracture Introduction While the burden of osteoporosis is projected to increase glob- ally, there is a paucity of research about osteoporosis in Africa and specifically East Africa. Within these regions, national osteoporosis guidelines are available and endorsed in only two countries—Egypt and South Africa [1]. While measures like FRAX (fracture risk assessment tool) allow for predic- tions for the risk of fragility hip fractures, specific variables required in FRAX calculations, such as country-specific inci- dence rate, are unavailable in many low-resource countries. Moreover, basic trends of fragility fractures are not well known in Africa, and there are no defined protocols in their management. In our working experience at the Orthopaedic Department of Kilimanjaro Christian Medical Centre (KCMC), very few elderly patients, if any, admitted with potential fragility hip fractures were assessed or received prophylactic therapy for osteoporosis. Similarly, research in South Africa report- ed that only two out of every ten elderly patients with * Munyaradzi Tsabasvi mtsabasvi@yahoo.com 1 Kilimanjaro Christian Medical University College, Moshi, Tanzania 2 University of Pennsylvania School of Medicine, Philadelphia, PA, USA Arch Osteoporos (2017) 12:47 DOI 10.1007/s11657-017-0338-z