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Archives of Osteoporosis

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01-12-2020 | Femoral Fracture | Original Article

Comparison of hip subregion bone mineral density to the type of proximal femur fracture

Authors: Yongun Cho, Ingyu Lee, Sang Hoon Ha, Jin Hun Park, Jai Hyung Park

Published in: Archives of Osteoporosis | Issue 1/2020

Abstract

Summary

Beta values of the intertrochanteric fracture group were about twice as high as those of the femoral neck fracture group. These results can be used to increase the awareness of proximal hip fracture among physicians and improve treatments and outcomes.

Purpose

To compare the BMD of the femoral neck region and the intertrochanteric region between the femoral neck fracture group and the intertrochanteric fracture group.

Methods

We did a retrospective review of radiographs of the proximal femoral fractures in patients registered from 2010 to 2017. A total of 329 patients were classified into the femoral neck fracture group (group A, n = 162) and the femur intertrochanteric fracture group (group B, n = 167). We did intergroup comparisons of age, sex, BMI (body mass index), and bone mineral density (BMD) of the neck and intertrochanteric region, adjusting for age. We did multiple logistic regression analysis among these parameters.

Results

The BMD of the femoral neck and intertrochanteric was statistically significantly different between the two groups (p < 0.001), and the BMD of the femur intertrochanteric was also significantly different between the two groups (p < 0.001). BMD of both regions in the intertrochanteric fracture group was lower than that of the femoral neck fracture group. In linear regression analysis, the beta values of the intertrochanteric fracture group were about twice as high as those of the femoral neck fracture group.

Conclusion

In linear regression analysis, the beta values of the intertrochanteric fracture group were about twice as high as those of the femoral neck fracture group.

Hodsman AB, Leslie WD, Tsang JF, Gamble GD (2008) 10-year probability of recurrent fractures following wrist and other osteoporotic fractures in a large clinical cohort: an analysis from the Manitoba Bone Density Program. Arch Intern Med 168(20):2261–2267. https://doi.org/10.1001/archinte.168.20.2261CrossRefPubMed

Gardner MJ, Brophy RH, Demetrakopoulos D, Koob J, Hong R, Rana A, Lin JT, Lane JM (2005) Interventions to improve osteoporosis treatment following hip fracture. A prospective, randomized trial. J Bone Joint Surg Am 87(1):3–7. https://doi.org/10.2106/JBJS.D.02289CrossRefPubMed

Melton LJ 3rd, Chrischilles EA, Cooper C, Lane AW, Riggs BL (1992) Perspective. How many women have osteoporosis? J Bone Miner Res 7(9):1005–1010. https://doi.org/10.1002/jbmr.5650070902CrossRefPubMed

Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289. https://doi.org/10.1007/bf01623184CrossRefPubMed

Juby AG, De Geus-Wenceslau CM (2002) Evaluation of osteoporosis treatment in seniors after hip fracture. Osteoporos Int 13(3):205–210. https://doi.org/10.1007/s001980200015CrossRefPubMed

Lee KH, Kim JY (2014) Incidence and risk factors of subsequent hip fractures in Korea: multicenter study. 29(7):992–994. https://doi.org/10.3346/jkms.2014.29.7.992

Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ III (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137(9):1001–1005CrossRef

Baudoin C, Fardellone P, Bean K, Ostertag-Ezembe A, Hervy F (1996) Clinical outcomes and mortality after hip fracture: a 2-year follow-up study. Bone 18(3 Suppl):149S–157S. https://doi.org/10.1016/8756-3282(95)00496-3CrossRefPubMed

Mullen JO, Mullen NL (1992) Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. Clin Orthop Relat Res (280):214–222

10.

Im GI, Lim MJ (2011) Proximal hip geometry and hip fracture risk assessment in a Korean population. Osteoporos Int 22(3):803–807. https://doi.org/10.1007/s00198-010-1301-7CrossRefPubMed

11.

Guerra MT, Viana RD, Feil L, Feron ET, Maboni J, Vargas AS (2017) One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil. Rev Bras Ortop 52(1):17–23. https://doi.org/10.1016/j.rboe.2016.11.006CrossRefPubMed

12.

Meinberg E, Agel J, Roberts C, Karam MD, Kellam JF (2018) Fracture and dislocation classification compendium—2018. 32:S1–S170. https://doi.org/10.1097/BOT.0000000000001063

13.

Fox KM, Cummings SR, Williams E, Stone K, Study of Osteoporotic F (2000) Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporos Int 11(12):1018–1023. https://doi.org/10.1007/s001980070022CrossRefPubMed

14.

Greenspan SL, Myers ER, Kiel DP, Parker RA, Hayes WC, Resnick NM (1998) Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med 104(6):539–545. https://doi.org/10.1016/s0002-9343(98)00115-6CrossRefPubMed

15.

Pande I, O'Neill TW, Pritchard C, Scott DL, Woolf AD (2000) Bone mineral density, hip axis length and risk of hip fracture in men: results from the Cornwall Hip Fracture Study. Osteoporos Int 11(10):866–870. https://doi.org/10.1007/s001980070046CrossRefPubMed

16.

Lewiecki EM (2010) Bone densitometry and vertebral fracture assessment. Curr Osteoporos Rep 8(3):123–130. https://doi.org/10.1007/s11914-010-0018-zCrossRefPubMed

17.

Hahnhaussen J, Hak DJ, Weckbach S, Ertel W, Stahel PF (2011) High-energy proximal femur fractures in geriatric patients: a retrospective analysis of short-term complications and in-hospital mortality in 32 consecutive patients. Geriatr Orthop Surg Rehabil 2(5–6):195–202CrossRef

18.

Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9(12):1889–1894. https://doi.org/10.1002/jbmr.5650091208CrossRefPubMed

19.

Kok LM, van der Steenhoven TJ, Nelissen RG (2011) A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures. Int Orthop 35(10):1545–1551. https://doi.org/10.1007/s00264-010-1176-4CrossRefPubMed

20.

Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113(4):366–374. https://doi.org/10.1115/1.2895414CrossRefPubMed

21.

Sawalha S, Parker MJ (2012) Characteristics and outcome in patients sustaining a second contralateral fracture of the hip. J Bone Joint Surg Br 94(1):102–106. https://doi.org/10.1302/0301-620X.94B1.27983CrossRefPubMed

22.

Dennison E, Mohamed MA, Cooper C (2006) Epidemiology of osteoporosis. Rheum Dis Clin N Am 32(4):617–629. https://doi.org/10.1016/j.rdc.2006.08.003CrossRef

23.

Bartl R, Frisch B (2009) Osteoporosis: diagnosis, prevention, therapy. Springer, BerlinCrossRef

24.

Li Y, Lin J, Cai S, Yan L, Pan Y, Yao X, Zhuang H, Wang P, Zeng Y (2016) Influence of bone mineral density and hip geometry on the different types of hip fracture. Bosn J Basic Med Sci 16(1):35–38. https://doi.org/10.17305/bjbms.2016.638CrossRefPubMedPubMedCentral

25.

Hey HW, Sng WJ, Lim JL, Tan CS, Gan AT, Ng JH, Kagda FH (2015) Interpretation of hip fracture patterns using areal bone mineral density in the proximal femur. Arch Orthop Trauma Surg 135(12):1647–1653. https://doi.org/10.1007/s00402-015-2326-3CrossRefPubMed

26.

Wu CC, Wang CJ, Shyu YI (2011) Variations in bone mineral density of proximal femora of elderly people with hip fractures: a case-control analysis. J Trauma 71(6):1720–1725. https://doi.org/10.1097/TA.0b013e3182185aebCrossRefPubMed

27.

Riggs BL, Wahner HW, Seeman E, Offord KP, Dunn WL, Mazess RB, Johnson KA, Melton LJ 3rd (1982) Changes in bone mineral density of the proximal femur and spine with aging. Differences between the postmenopausal and senile osteoporosis syndromes. J Clin Invest 70(4):716–723. https://doi.org/10.1172/jci110667CrossRefPubMedPubMedCentral

28.

Uitewaal PJ, Lips P, Netelenbos JC (1987) An analysis of bone structure in patients with hip fracture. Bone Miner 3(1):63–73PubMed

29.

Yu A, Carballido-Gamio J, Wang L, Lang TF, Su Y, Wu X, Wang M, Wei J, Yi C, Cheng X (2017) Spatial differences in the distribution of bone between femoral neck and trochanteric fractures. J Bone Miner Res 32(8):1672–1680. https://doi.org/10.1002/jbmr.3150CrossRefPubMedPubMedCentral

30.

Yang XJ, Sang HX, Bai B, Ma XY, Xu C, Lei W, Zhang Y (2018) Ex vivo evaluation of hip fracture risk by proximal femur geometry and bone mineral density in elderly Chinese women. Med Sci Monit 24:7438–7443. https://doi.org/10.12659/MSM.910876CrossRefPubMedPubMedCentral

Title: Comparison of hip subregion bone mineral density to the type of proximal femur fracture
Authors: Yongun Cho
Ingyu Lee
Sang Hoon Ha
Jin Hun Park
Jai Hyung Park
Publication date: 01-12-2020
Publisher: Springer London
Keywords: Femoral Fracture
Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2020
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-020-00789-2

At a glance: The STEP trials

Springer Medicine

Comparison of hip subregion bone mineral density to the type of proximal femur fracture

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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