Differences in Bone Mineral Density and Hip Geometry in Trochanteric and Cervical Hip Fractures in Elderly Chinese Patients

Abstract

Objective To assess the differences in bone mineral density (BMD) and hip geometry in trochanteric and cervical hip fractures in elderly Chinese patients. Methods A consecutive series of 196 hip fracture patients aged over 50 years was recruited from November 2013 to October 2015, including 109 cases of cervical fractures (36 males and 73 females) and 87 cases of trochanteric fractures (34 males and 53 females). All patients were evaluated through dual‐energy X‐ray absorptiometry, and baseline characteristics, BMD and structural parameters were collected and reviewed. Results There were statistically significant differences in age, height, and body mass index between patients with each type of fracture, and patients with trochanteric fractures were older than those with cervical fractures, especially in women. The BMD in trochanteric fractures was markedly lower than in cervical fractures in all five sites of the hip by an approximate reduction of 10%, in both men and women. The cross‐sectional area, cross‐sectional moment of inertia, and the cortical thickness in the cervical fracture group were significantly higher than in the trochanteric fracture group. However, the buckling ratio of both the femoral neck and trochanteric region were significantly lower in the cervical fracture group. Age (/10 years), cross‐sectional moment of inertia in femoral neck and buckling ratio in trochanteric region were significant risk factors for trochanteric fractures compared with cervical fractures. Conclusions Compared with cervical hip fractures, patients with trochanteric fractures were older, had a lower BMD, and had less bone mechanical strength, especially in female patients. Age, femoral neck cross‐sectional moment of inertia (FNCSMI), and trochanteric region buckling ratio (ITBR) were stronger risk factors for trochanteric hip fractures than for cervical fractures.

Risk Factors and Trends Associated With Mortality Among Adults With Hip Fracture in Singapore

“…Hips fracturing at the trochanteric region have been documented to have reduced cortical thickness, 25 bone mineral density, and bone mechanical strength. 26 These fractures can vary in morphology, ranging from simple fractures to highly comminuted, unstable configurations. As these fractures are usually treated with fixation, patients may not be able to bear weight immediately.…”

“…One challenge for future work in Singapore is to compare hip fracture mortality with mortality in a nonfracture cohort matched by CCI score.Compared with cervical fractures, trochanteric fractures are associated with advanced age and with higher CCI score,24 implying a more fragile group of patients. Hips fracturing at the trochanteric region have been documented to have reduced cortical thickness,25 bone mineral density, and bone mechanical strength 26. These fractures can vary in morphology, ranging from simple fractures to highly comminuted, unstable configurations.…”

Partial pressure of oxygen level at admission as a predictor of postoperative pneumonia after hip fracture surgery in a geriatric population: a retrospective cohort study

“… 1 Hip fractures are classified according to the anatomical location of fracture into fractures of the intertrochanteric regions and femoral neck. 2 3 Several treatment options exist for hip fractures, including total hip arthroplasty (THA), hemiarthroplasty, internal fixation and non-operative treatment. Surgery to treat hip fracture has been known as the gold-standard treatment in the geriatric population.…”

Biomechanical comparison of medial sustainable nail and proximal femoral nail antirotation in the treatment of an unstable intertrochanteric fracture

“…As one of the most common osteoporotic fractures in the elderly, intertrochanteric fractures account for approximately 40% to 50% of all hip fractures, of which 50% to 60% are unstable fractures. 1 , 2 It is considered to be a potentially fatal disease with high mortality and disability rates due to the difficulty of treatment, which has placed a great burden on society.…”