J Bone Metab.  2013 May;20(1):11-15. 10.11005/jbm.2013.20.1.11.

Analysis of Clinical Features of Hip Fracture Patients with or without Prior Osteoporotic Spinal Compression Fractures

• Kim GD
• Kim YJ
• Chae SU
• Choi DH

• KMID: 2286307
• DOI: http://doi.org/10.11005/jbm.2013.20.1.11

Abstract

BACKGROUND
To analyze and compare the clinical characteristics including bone mineral density (BMD) in a group who had operation of hip fracture with or without prior osteoporotic spinal compression fractures.
METHODS
Two hundred forty patients who had undergone operation of hip fractures were evaluated, 127 patients who had with prior osteoporotic spinal compression fractures were in group I, and 113 patients without prior spinal fractures were in group II. In each group, we measured age, gender, body mass index (BMI, kg/m2), BMD (mg/cm3), type of hip fractures, concomitant diseases, presence of secondary hip fracture and history of percutaneous vertebroplasty.
RESULTS
The mean age of group I was 79.4 years (male/female: 28/99) and that of group II was 77.6 years (male/female: 37/76). The mean BMI of group I was 21.3 kg/m2 and that in group II was 22.0 kg/m2. The mean BMD and T-score of group I were 41.1 mg/cm3 and -4.45 and those in group II were 51.0 mg/cm3 and -4.17 (P<0.05). The numbers of patients of neck and intertrochanter fracture of group I were 31 and 96 patients and those in group II were 61 and 52 patients. Sixty in group I and 45 in group II patients had concomitant diseases. Thirteen patients had undergone percutaneous vertebroplasty and 18 patients (7.5%) had second hip fractures.
CONCLUSIONS
The hip fracture patients who had with prior osteoporotic spinal compression fractures had lower BMD compared to the hip fracture patients without previous spinal compression fractures.

Keyword

Bone density; Hip fractures; Spinal fractures

MeSH Terms

Body Mass Index
Bone Density
Fractures, Compression
Hip
Hip Fractures
Humans
Neck
Spinal Fractures
Vertebroplasty

Reference

1. Black DM, Arden NK, Palermo L, et al. Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1999. 14:821–828.

2. Klotzbuecher CM, Ross PD, Landsman PB, et al. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000. 15:721–739.

3. Li YA, Lin CL, Chang MC, et al. Subsequent vertebral fracture after vertebroplasty: incidence and analysis of risk factors. Spine (Phila Pa 1976). 2012. 37:179–183.

4. Hardouin P, Grados F, Cotten A, et al. Should percutaneous vertebroplasty be used to treat osteoporotic fractures? An update. Joint Bone Spine. 2001. 68:216–221.

5. Fribourg D, Tang C, Sra P, et al. Incidence of subsequent vertebral fracture after kyphoplasty. Spine (Phila Pa 1976). 2004. 29:2270–2276.

6. Black DM, Palermo L, Nevitt MC, et al. Comparison of methods for defining prevalent vertebral deformities: the Study of Osteoporotic Fractures. J Bone Miner Res. 1995. 10:890–902.

7. Schousboe JT, Fink HA, Lui LY, et al. Association between prior non-spine non-hip fractures or prevalent radiographic vertebral deformities known to be at least 10 years old and incident hip fracture. J Bone Miner Res. 2006. 21:1557–1564.

8. Siris ES, Genant HK, Laster AJ, et al. Enhanced prediction of fracture risk combining vertebral fracture status and BMD. Osteoporos Int. 2007. 18:761–770.

9. Melton LJ 3rd, Atkinson EJ, Cooper C, et al. Vertebral fractures predict subsequent fractures. Osteoporos Int. 1999. 10:214–221.

10. Haentjens P, Autier P, Collins J, et al. Colles fracture, spine fracture, and subsequent risk of hip fracture in men and women. A meta-analysis. J Bone Joint Surg Am. 2003. 85-A:1936–1943.

11. Mazzantini M, Carpeggiani P, d'Ascanio A, et al. Long-term prospective study of osteoporotic patients treated with percutaneous vertebroplasty after fragility fractures. Osteoporos Int. 2011. 22:1599–1607.

12. Mitani S, Shimizu M, Abo M, et al. Risk factors for second hip fractures among elderly patients. J Orthop Sci. 2010. 15:192–197.

13. Schrøder HM, Petersen KK, Erlandsen M. Occurrence and incidence of the second hip fracture. Clin Orthop Relat Res. 1993. (289):166–169.

14. Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995. 332:767–773.

15. Hinton RY, Lennox DW, Ebert FR, et al. Relative rates of fracture of the hip in the United States. Geographic, sex, and age variations. J Bone Joint Surg Am. 1995. 77:695–702.

16. Finsen V, Benum P. The second hip fracture. An epidemiologic study. Acta Orthop Scand. 1986. 57:431–433.

17. NIH Consensus Development Panel on Osteoporosis Prevention Diagnosis and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001. 285:785–795.

18. Kim SR, Ha YC, Park YG, et al. Orthopedic surgeon's awareness can improve osteoporosis treatment following hip fracture: a prospective cohort study. J Korean Med Sci. 2011. 26:1501–1507.

19. Kaufman JD, Bolander ME, Bunta AD, et al. Barriers and solutions to osteoporosis care in patients with a hip fracture. J Bone Joint Surg Am. 2003. 85-A:1837–1843.

20. Bouxsein ML, Kaufman J, Tosi L, et al. Recommendations for optimal care of the fragility fracture patient to reduce the risk of future fracture. J Am Acad Orthop Surg. 2004. 12:385–395.