Skip to main content
Top
Published in: Archives of Osteoporosis 1/2017

01-12-2017 | Original Article

Osteoporotic hip fractures in Black South Africans: a regional study

Authors: F. Paruk, G. Matthews, B. Cassim

Published in: Archives of Osteoporosis | Issue 1/2017

Login to get access

Abstract

Summary

Osteoporotic hip fractures are thought to be rare in Blacks however, this study from South Africa shows a significant increase in the number of hip fracture in Blacks. With the expected increase in older people, osteoporotic fractures will pose a major health problem and screening guidelines needed to be implemented.

Introduction

Developing countries are predicted to bear the burden of osteoporosis in the coming decades. This study was undertaken to review earlier reports that osteoporotic hip fractures are rare in Black Africans.

Methods

In an observational study, the incidence rates and relative risk ratios (RRR) of osteoporotic hip fractures were calculated in the Black population, aged 60 years and older, residing in the eThekwini region of South Africa. All Black subjects, presenting with a minimal trauma hip fracture to five public hospitals in the region, entered the study. Descriptive statistics were applied to show differences in age and sex.

Results

Eighty-seven subjects were enrolled in the study with a mean age of 76.5 ± 10.5 years and the sex ratio of women to men was 2.5:1. Although men were younger than women, this was not significant (74.2 ± 12.3 vs. 77.4 ± 9.6 years, p = 0.189). The age-adjusted rate was 69.2 per 100,000 p.a. for women and 73.1 per 100,000 p.a. for men. There was a significant increase in the relative risk ratios for hip fractures after the age of 75 years in the total cohort and in women and men. Except for the 65–69-year age group, there was no significant difference in the age-adjusted RRR between women and men.

Conclusion

This study represents the largest number of hip fractures recorded in Black Africans. Although the incidence rate is approximately tenfold higher than previously recorded, it remains amongst the lowest globally. A national registry inclusive of private and public sector is required to establish the true incidence rate of hip fractures in Black Africans.
Literature
4.
go back to reference Solomon L (1968) Osteoporosis and fracture of the femoral neck in South African Bantu Blacks. J Bone Joint Surg 36(50B):2–1 Solomon L (1968) Osteoporosis and fracture of the femoral neck in South African Bantu Blacks. J Bone Joint Surg 36(50B):2–1
5.
go back to reference Solomon L (1979) Bone density in ageing Caucasians and African populations. Lancet 2(8156–8157):1326–1330CrossRefPubMed Solomon L (1979) Bone density in ageing Caucasians and African populations. Lancet 2(8156–8157):1326–1330CrossRefPubMed
7.
go back to reference Asprey TJ, Prentice A, Cole TJ et al (1996) Low bone mineral content is common but osteoporotic fractures are rare in elderly rural Gambian women. J Bone Miner Res 11(7):1019–1025CrossRef Asprey TJ, Prentice A, Cole TJ et al (1996) Low bone mineral content is common but osteoporotic fractures are rare in elderly rural Gambian women. J Bone Miner Res 11(7):1019–1025CrossRef
9.
go back to reference Maalouf G, Gannag’e-Yared MH, Ezzedine J et al (2007) Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact 7(2):131–143PubMed Maalouf G, Gannag’e-Yared MH, Ezzedine J et al (2007) Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact 7(2):131–143PubMed
12.
go back to reference Jervas E, Onwukamuche CK, Anyanwu GE, Ugochukwu AI (2011) Incidence of fall related hip fractures among the elderly persons in Owerri, Nigeria. Asian J Med Sci 3(3):110–114 Jervas E, Onwukamuche CK, Anyanwu GE, Ugochukwu AI (2011) Incidence of fall related hip fractures among the elderly persons in Owerri, Nigeria. Asian J Med Sci 3(3):110–114
13.
go back to reference Basu D (2010) Determination of bone mass and prevalence of vertebral deformities in postmenopausal black women in South Africa. PhD dissertation, University of the Witwatersrand, South Africa. University of the Witwatersrand, South Africa Basu D (2010) Determination of bone mass and prevalence of vertebral deformities in postmenopausal black women in South Africa. PhD dissertation, University of the Witwatersrand, South Africa. University of the Witwatersrand, South Africa
15.
go back to reference Conradie M (2008) A comparative study of known determinants of bone strength in black and white South African females, in Division of Endocrinology and Metabolism, PhD dissertation, Tygerberg Academic Hospital. University of Stellenbosch Conradie M (2008) A comparative study of known determinants of bone strength in black and white South African females, in Division of Endocrinology and Metabolism, PhD dissertation, Tygerberg Academic Hospital. University of Stellenbosch
25.
go back to reference Clark P, Lavielle P, Franco-Marina F et al (2005) Incidence rates and life-time risk of hip fractures in Mexicans over 50 years of age: a population-based study. Osteoporos Int 12:2025–2203CrossRef Clark P, Lavielle P, Franco-Marina F et al (2005) Incidence rates and life-time risk of hip fractures in Mexicans over 50 years of age: a population-based study. Osteoporos Int 12:2025–2203CrossRef
26.
go back to reference Hannan MT, Felson DT, Dawson-Hughes B et al (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis study. JBMR 15(4):710–720CrossRef Hannan MT, Felson DT, Dawson-Hughes B et al (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis study. JBMR 15(4):710–720CrossRef
29.
go back to reference William G, Hawkes WG, Wehren L et al (2006) Gender differences in functioning after hip fracture. J Gerontol A Biol Sci Med Sci 61(5):495–499CrossRef William G, Hawkes WG, Wehren L et al (2006) Gender differences in functioning after hip fracture. J Gerontol A Biol Sci Med Sci 61(5):495–499CrossRef
30.
33.
go back to reference South African History Online. Pass laws in South Africa 1800–1994. (2000) Available online at: www.sahistory.org.za › History of Women's struggle in South Africa. Accessed at 17 June 2016 South African History Online. Pass laws in South Africa 1800–1994. (2000) Available online at: www.​sahistory.​org.​za › History of Women's struggle in South Africa. Accessed at 17 June 2016
38.
go back to reference Filip RS, Zagorski J (2005) Osteoporosis risk factors in rural and urban women from the Lublin region of Poland. Ann Agric Environ Med 12(1):21–26PubMed Filip RS, Zagorski J (2005) Osteoporosis risk factors in rural and urban women from the Lublin region of Poland. Ann Agric Environ Med 12(1):21–26PubMed
39.
go back to reference Finsen V, Benum P (1987) Changing incidence of hip fracture in rural and urban areas of central Norway. Clin Orthop Relat Res 218:104–110 Finsen V, Benum P (1987) Changing incidence of hip fracture in rural and urban areas of central Norway. Clin Orthop Relat Res 218:104–110
45.
go back to reference Hough FS, Ascott-Evans BH, Brown SL et al (2010) NOFSA guideline for the diagnosis and management of osteoporosis. JEMDSA 15(3):Supple 2 Hough FS, Ascott-Evans BH, Brown SL et al (2010) NOFSA guideline for the diagnosis and management of osteoporosis. JEMDSA 15(3):Supple 2
Metadata
Title
Osteoporotic hip fractures in Black South Africans: a regional study
Authors
F. Paruk
G. Matthews
B. Cassim
Publication date
01-12-2017
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-017-0409-1

Other articles of this Issue 1/2017

Archives of Osteoporosis 1/2017 Go to the issue