Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

Abstract

CONTEXT: It is believed that about 25% of menopausal women in the USA will exhibit some kind of fracture as a consequence of osteoporosis. Fractures of the proximal femur are associated with a greater number of deaths and disabilities and higher medical expenses than all the other osteoporotic fractures together. OBJECTIVE: To study the clinical and epidemiological features of patients with proximal femur fracture in hospitals in São Paulo. DESIGN: Transversal and retrospective study. LOCAL: Hospital São Paulo and Hospital Servidor Público Estadual "Francisco Morato Oliveira". PARTICIPANTS: Patients aged sixty-five years or more hospitalized because of proximal femur fracture, from March to November 1996 (N = 73). This group was compared to patients of the same age without fracture of the proximal femur. INTERVENTION: Evaluation of weight, height, body mass index; lifestyle habits (physical activity at home, ingestion of dairy calcium, drinking of coffee, smoking habit), gynecological history (ages at menarche and menopause, number of pregnancies and lactations), previous morbidity, use of medications, history of previous fractures, family history of osteoporosis. MEASUREMENT: The comparison of the different data regarding lifestyle habits between the two groups was made using the chi-squared test. Other data were analyzed using the Mann -- Whitney test. P £ 0.05 was considered significant. RESULTS: We noted a predominance of proximal femur fracture among females in relation to males (a female/male ratio of 3.3:1) with a progressive increase in the frequency of proximal femur fracture with age in both sexes. The group with proximal femur fracture, in comparison with the control group, showed a lower body mass index, less physical activity, and a greater number of pregnancies and lactations. Other data were not different. CONCLUSION: In accordance with the literature, we found a predomination of proximal femur fracture in women in relation to men, and a favorable effect of higher body mass index and physical activity for decreasing the frequency of proximal femur fracture. We also discuss the role of pregnancies and lactation on the frequency of proximal femur fracture.

Epidemiology of Femur Fractures in the Elderly and Cost to the State of Paraná, Brazil

“…The total standardized incidence rate (≥ 60 years) was higher in females and increased progressively with increasing age similar to that in other epidemiological studies. 3,11 The female and total rates in Paraná were superior to the national one, in agreement with the findings of Silveira et al, 11 who believed that the incidence of femur fracture in the elderly is higher in the southern region due to colder temperatures and lower incidence of sunlight, which favors osteoporosis. Taking this into account, we expected that the rate of fractures in Paraná (24º00'S, 51º00W) would be similar to that calculated for the same age group (≥ 60 years) in the city of Marília, São Paulo (50.03 / 10 thousand female inhabitants and 18.73 / 10 thousand male inhabitants) and to exceed Fortaleza's rates (27.5 / 10 thousand female inhabitants and 13/10 thousand male inhabitants); however, we obtained a rate similar to that of Fortaleza (03º 43' S, 38º 32' W)and well below that of Marília (22º 12'S, 49º 56' W).…”

“…The study presented results consistent with the literature regarding the higher incidence of fractures in females and in the higher age groups. 3,10,11 The male / female ratio observed of 1: 2.01 was similar to that in Sobral, Ceara (1:1.7), and lower than that in Recife, Pernambuco (1:3.02). Women are more likely to develop osteoporosis and, consequently, fractures as observed in the BRAZOS study.…”

“…2 The incidence of fracture increases with age and maintains a higher proportion in females. 3 Citation: Oliveira CC, Borba VZC. Osteoporosis in brazilian patients awaiting knee arthroplasty.…”

Evolução funcional nas fraturas da extremidade proximal do fêmur

“…The socioeconomical impact of fractures on hip region is very strong, leading to increased morbidity and mortality rates. This study evidenced a prevalence of femoral fractures in women (60.29%) and aged people (75.84 years), consistently with literature [17][18][19] Rocha et al 18 found, in a retrospective study on proximal femoral fractures, a mean age of 68.5 years. Female gender showed higher mean ages compared to male gender, with values of 76.912 years for the first group, and 65.69 years for the second one.…”

“…Transtrochanteric fractures were prevalent in our study, as well as in the study by Rocha et al 18 , however, other studies show no significant difference between the kind of fracture and higher incidence on males or females. 17 Many factors, not assessed in this study, are involved in simple falls; this kind of trauma remains as the major cause of femoral fractures, totaling 85.30% of the total mechanisms of trauma studied. The presence of comorbidities was an important factor for therapeutic approach, time of hospital stay, for prognosis and change on quality of life.…”