Hip fracture

Summary

Hip fracture (MONDO:0005327) is a disease with 5 GWAS associations across 2 studies and 565 clinical trials. Top therapeutic interventions include zoledronic acid anhydrous, tranexamic acid, and metamizole. A subtype of bone fracture — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• GWAS associations: 5
• Clinical trials: 565

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	hip fracture
Mondo ID	MONDO:0005327
EFO	EFO:0003964
MeSH	D006620
SNOMED CT	263225007
Anatomy (UBERON)	UBERON:0000981
Is cancer (heuristic)	no

Data availability: 5 GWAS associations (2 studies).

Disease family

This is a subtype of bone fracture. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: injury › bone fracture › hip fracture

Related subtypes (6): spinal fracture, humerus fracture, tibia fracture, ulna fracture, radius fracture, jaw fracture

Subtypes (1): femoral neck fracture

Genetics & variants

GWAS landscape

5 GWAS associations across 2 studies. Top hits map to 3 distinct genes (as reported by GWAS).

Top associations by p-value

rsID	p-value	Gene	Risk allele	Odds ratio
rs429358	4e-11	APOE	C	1.14
rs11088458	4e-10	LINC01700 - LINC02940	G	1.11
rs62028332	1e-09	LINC02128 - LINC02127	G	1.15
rs35339719	2e-09	SPINK2 - REST	G	1.11
rs4142680	2e-09	HOXC8, HOXC6	T	1.12

Top studies (by case count)

Study	Lead author	Year	Cases	Controls	Title
GCST90161240	Nethander M	2022	11,516	723,838	Assessment of the genetic and clinical determinants of hip fracture risk: Genome-wide association and Mendelian randomization study.
GCST90044632	Jiang L	2021	1,930	454,418	A generalized linear mixed model association tool for biobank-scale data.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

Tier	Variants
Tier 1: coding	1
Tier 2: splice/UTR	1
Tier 3: regulatory	0
Tier 4: intronic/intergenic	3

MAF distribution

Bucket	Variants
common (>=0.05)	5
low_freq (0.01-0.05)	0
rare (<0.01)	0
unknown	0

Functional consequences

Consequence	Count
intergenic_variant	2
missense_variant	1
intron_variant	1
3_prime_UTR_variant	1

Top variants

rsID	Chr	Pos	Alleles	MAF	Consequence	Gene	p-value	Tier
rs429358	19	44908684	T>C	0.17	missense_variant	APOE	4e-11	Tier 1: coding
rs11088458	21	38978194	A>G,T	0.3	intron_variant	LINC01700 - LINC02940	4e-10	Tier 4: intronic/intergenic
rs62028332	16	50991557	G>A	0.13	intergenic_variant	LINC02128 - LINC02127	1e-09	Tier 4: intronic/intergenic
rs35339719	4	56893371	G>A,T	0.26	intergenic_variant	SPINK2 - REST	2e-09	Tier 4: intronic/intergenic
rs4142680	12	54011406	C>G,T	0.41	3_prime_UTR_variant	HOXC8, HOXC6	2e-09	Tier 2: splice/UTR

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated for this disease

0 approved, 15 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Development status
Aspirin	Phase 3 (in late-stage trials)
Calcium	Phase 3 (in late-stage trials)
Cholecalciferol	Phase 3 (in late-stage trials)
Emiplacel	Phase 3 (in late-stage trials)
Epoetin Beta	Phase 3 (in late-stage trials)
Ergocalciferol	Phase 3 (in late-stage trials)
Ferric Carboxymaltose	Phase 3 (in late-stage trials)
Ferrous Sulfate	Phase 3 (in late-stage trials)
HYDROXYETHYL STARCH 130/0.4	Phase 3 (in late-stage trials)
Heparin Sodium	Phase 3 (in late-stage trials)
Rivaroxaban	Phase 3 (in late-stage trials)
Rosuvastatin	Phase 3 (in late-stage trials)
Teriparatide	Phase 3 (in late-stage trials)
Testosterone	Phase 3 (in late-stage trials)
Tranexamic Acid	Phase 3 (in late-stage trials)

Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Bupivacaine, Nandrolone Decanoate, Sodium Chloride, Tramadol.

Clinical trials & evidence

Clinical trials

Clinical trials: 565.

Phase distribution (across all retrieved trials)

Phase	Trials
Not specified	453
PHASE4	58
PHASE3	26
PHASE2	16
EARLY_PHASE1	5
PHASE2/PHASE3	4
PHASE1	2
PHASE1/PHASE2	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT03063892	PHASE4	RECRUITING	Effect of Tranexamic Acid (TXA) on Reduction of Postoperative Blood Transfusion
NCT05425355	PHASE4	RECRUITING	Intravenous vs Oral Acetaminophen in Postoperative Hip Fracture Adult Patients
NCT06278987	PHASE4	RECRUITING	Comparison of Cryoablation of Pericapsular Nerve Group (PENG) to Fascia Iliaca Catheter in Patients With a Hip Fracture
NCT06455813	PHASE4	RECRUITING	What Laxative Should be Used After Hip Fracture Surgery?
NCT06565910	PHASE4	RECRUITING	Bupivacaine Liposome Plus Bupivacaine or Ropivacaine for Pericapsular Nerve Group Block in Hip Arthroplasty (PENG)
NCT06567522	PHASE4	RECRUITING	Comparative Assessment of Effectiveness and Safety of L-ESPB Versus Absence of Locoregional Block in Hip Surgery
NCT06898814	PHASE4	RECRUITING	The Effects of Intravenous Iron on Mobility in Elderly Patients Following Hip Fracture Surgery
NCT07358299	PHASE4	NOT_YET_RECRUITING	Haemodynamic Effects and Complications of Continuous Versus Single-shot Spinal Anaesthesia for HIP Fracture Surgery
NCT00162617	PHASE4	UNKNOWN	The Effect of Liberal vs. Restrictive Transfusion Strategies on Rehabilitation After Hip Fracture Surgery
NCT00162630	PHASE4	COMPLETED	Fascia Iliaca Compartment Blockade as Analgesia for Hip Fractures in the Acute Phase
NCT00286936	PHASE4	TERMINATED	Incidence of Delirium in Hip Fracture Patients Randomized to Regular Hypnotics vs Placebo
NCT00323232	PHASE4	COMPLETED	Comparison of Treatment Outcomes in Hip Fractures Surgically Fixed With Either a Two or Four Hole Device.
NCT00424619	PHASE4	COMPLETED	A Randomised, Controlled Comparison of Vitamin D Strategies is Acute Hip Fracture Patients
NCT00582972	PHASE4	COMPLETED	Does Omeprazole Decrease Intestinal Calcium Absorption?
NCT00955565	PHASE4	COMPLETED	Accuracy of Navigation in Placement of Sacroiliac Screw
NCT01022983	PHASE4	WITHDRAWN	Preoperative Levosimendan and Heart Failure
NCT01084122	PHASE4	UNKNOWN	Efficacy and Safety of Intravenous Iron Sucrose in Patients With Hip Fracture to Prevent Perioperative Anemia
NCT01473082	PHASE4	COMPLETED	Proximal Femoral Nail Antirotation (PFNA) Versus PFNA Augmentation
NCT01593319	PHASE4	TERMINATED	Is Regional Anesthesia of the Hip Preferable Over Traditional Analgesia in the Acute Stage of the Management of Patients With a Fracture of the Hip
NCT01714336	PHASE4	COMPLETED	Does Tranexamic Acid Reduce the Need for Blood Transfusions in Patients Undergoing Hip Fracture Surgery?
NCT01850251	PHASE4	TERMINATED	Effects of a Supplement Enriched in Hydroxymethylbutyrate and Vitamin D on Muscle Strength in Hip Fracture
NCT01904071	PHASE4	COMPLETED	Ultrasound Guided Pain Control Versus Standard Treatment in Emergency Department HIP Fracture Patients
NCT01940536	PHASE4	WITHDRAWN	The Effect of Tranexamic Acid on Transfusion Rates in Intertrochanteric Hip Fractures
NCT01961895	PHASE4	COMPLETED	Lumbar Plexus Block Upon the Incidence of Ischemic Cardiovascular Events in Elderly Patients With Hip Fracture
NCT02248870	PHASE4	TERMINATED	Femoral Nerve Block With Bupivacaine and Adjuvant Dexamethasone in Patients With Hip Fracture
NCT02255591	PHASE4	COMPLETED	Shamrock Versus Lumbar Ultrasound Trident - Ultrasound Guided Block of the Lumbar Plexus
NCT02408419	PHASE4	WITHDRAWN	Obturator Nerve Block in Patients With Hip Fracture
NCT02540837	PHASE4	UNKNOWN	Obturator and Femoral Nerve Block in Patients With Hip Fracture
NCT02580227	PHASE4	UNKNOWN	Tranexamic Acid in Intertrochanteric and Subtrochanteric Femur Fractures
NCT02689024	PHASE4	TERMINATED	Delirium in Elderly Patients With Trauma of the Hip
NCT02774148	PHASE4	TERMINATED	Pain Control in Elderly Hip Fracture Patients: Is Intravenous Acetaminophen Superior to Oral Administration?
NCT02908516	PHASE4	TERMINATED	Safety and Efficacy of Oral TXA in Reducing Blood Loss and Transfusion in Hip Fractures
NCT03211286	PHASE4	COMPLETED	Effect of Intravenous Tranexamic Acid on Reduction of Blood Losses in Hip Fracture Patients
NCT03213886	PHASE4	COMPLETED	The Effect of Supplementation of Vitamin D Deficiency in Older People With Acute Hip Fracture:
NCT03226080	PHASE4	WITHDRAWN	GA/Spinal vs. GA/Spinal/NMB for Operative Repair of Hip Fracture
NCT03289858	PHASE4	COMPLETED	Randomized Controlled Trial for Exparel Hip Fracture
NCT03588689	PHASE4	COMPLETED	Continuous Fascia Iliaca Block for Acute Hip Fractures
NCT03843970	PHASE4	UNKNOWN	Hemodynamic Safety of Levobupivacaine vs Bupivacaine in Patients Over 65 Years Undergoing Hip Surgery
NCT03955458	PHASE4	WITHDRAWN	EXPAREL Facia Iliaca Compartment Block for Intertrochanteric Hip Fracture
NCT04773301	PHASE4	COMPLETED	Comparative Study Between Levobupivacaine and Ropivacaine in the Hip Fractures of the Elderly

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
ZOLEDRONIC ACID ANHYDROUS	4	13
TRANEXAMIC ACID	4	5
METAMIZOLE	4	4
LEVOBUPIVACAINE	4	3
SUGAMMADEX	4	3
EPHEDRINE	4	2
ERGOCALCIFEROL	4	2
FERRIC CARBOXYMALTOSE	4	2
IRON SUCROSE	4	2
REMIMAZOLAM	4	2
ALFENTANIL	4	1
BISACODYL	4	1
BUPIVACAINE HYDROCHLORIDE	4	1
CHOLECALCIFEROL	4	1
DESFLURANE	4	1
DICLOFENAC	4	1
ENOXAPARIN SODIUM	4	1
ESOMEPRAZOLE	4	1
FERRIC DERISOMALTOSE	4	1
FERROUS SULFATE	4	1
FLUMAZENIL	4	1
HALOPERIDOL	4	1
HYDROXYETHYL STARCH 130/0.4	4	1
IBUPROFEN	4	1
KETOCONAZOLE	4	1
LEVOKETOCONAZOLE	4	1
METHADONE HYDROCHLORIDE	4	1
NANDROLONE DECANOATE	4	1
NAPROXEN	4	1
NOREPINEPHRINE	4	1