The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients

Hwa Jae Jeong; Jae-Yeol Choi; Jinmyung Lee; Kyubo Choi; Byeongsam Jeon

doi:10.4055/jkoa.2010.45.3.228

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Jeong, Choi, Lee, Choi, and Jeon: The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(3): 228-233.

Published online: 9 June 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.3.228

The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients

Hwa Jae Jeong, M.D., Jae-Yeol Choi, M.D., Jinmyung Lee, M.D., Kyubo Choi, M.D., Byeongsam Jeon, M.D.

Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Jae-Yeol Choi, M.D. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, 108, Pyung-dong, Jongro-gu, Seoul 110-746, Korea. TEL: +82-2-2001-2405, FAX: +82-2-2001-2176, hippo@samsung.co.kr

Received 13 October 2009 Accepted 10 March 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The incidence of hip fracture associated with disability, pain and death increases in old age. The decreased bone mineral density, particularly due to osteoporosis, has been described as one of factors associated with the proximal femur fracture. Therefore, this study, measured the bone mineral density (BMD) of elderly patients with hip fractures to better understand the relationship between osteoporosis and proximal femur fractures.

Materials and Methods

The bone densities of the femoral neck and trochanteric region were measured by dual energy x-ray absorptiometry (DEXA) in 60 patients with femur neck fractures and 82 patients with intertrochanteric fractures. Individuals (158 subjects) who had their BMD checked in a Health promotion center without a proximal femoral fracture were selected as a control group. The patients were divided into subgroups according to gender and type of fracture.

Results

The BMD of the hip in the patients with proximal femur fractures was significantly lower than that of the control subjects. The intertrochanteric fracture group had a lower T-score than the femur neck fracture group. However the differences were not significant. No significant differences were found between the displaced and undisplaced femur neck fracture groups and between the stable and unstable intertrochanteric fracture groups.

Conclusion

The BMD in elderly patients with proximal femur fracture was significantly lower than that of the control group. There was a poorer association between a decreased BMD and femur neck fractures in elderly males. There were no association between the BMD and location of the fracture or fracture type.

Keywords: proximal femur fracture, bone mineral density, osteoporosis

Figures and Tables

Figure 1

T-score values in patients with proximal femur fracture (A: Male, B: Female) (groups femur neck fracture, squares ; intertrochanteric fracture, triangle and normal group, circle). Symbols indicate means of the T-score and bars indicate SD. Solid line, the BMD of femur neck, dotted line, the BMD of trochanteric region (p>0.05, analysis of variance [ANOVA] by Scheffe's method).

Table 1

Distribution of the Control and Fracture Subjects (p=0.107, Analysis of Chi-square Test)

Table 2

Distribution of Age (p=0.084, Analysis of Kruskal-wallis Test)

Table 3

Bone Mineral Densitiy of Femoral Neck Fracture Patient according to Garden Classification

Table 4

Bone Mineral Densitiy of Trochanteric Fracture Patient according to Evans Classification

Table 5

Bone Mineral Densitiy of Femoral Neck Fracture Patient according to Age Distribution

Table 6

Bone Mineral Densitiy of Trochanteric Fracture Patient according to Age Distribution

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