Preferential Low Bone Mineral Density of the Femoral Neck in Patients with a Recent Fracture of the Proximal Femur

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 1991 Jun 1

PMID 1790402

Citations 26

Authors

T Chevalley

R Rizzoli

V Nydegger

D Slosman

L Tkatch

C H Rapin

H VASEY

J P Bonjour

Affiliations

Soon will be listed here.

Abstract

Bone mass is an important determinant of resistance to fractures. Whether bone mineral density (BMD) in subjects with a fracture of the proximal femur (hip fracture) is different from that of age-matched controls is still debated. We measured BMD of the femoral neck (FN) on the opposite side to the fracture, as well as femoral shaft (FS) and lumbar spine (LS) BMD by dual-photon absorptiometry in 68 patients (57 women and 11 men, mean age 78.8 +/- 1.0) 12.4 +/- 0.8 days after hip fracture following a moderate trauma. These values were compared with BMD of 93 non-fractured elderly control subjects (82 women and 11 men), measured during the same period. As compared with the controls, FN BMD was significantly lower in fractured women (0.592 +/- 0.013 v. 0.728 +/- 0.014 g/cm2, P less than 0.001) and in fractured men (0.697 +/- 0.029 v. 0.840 +/- 0.052, P less than 0.05). Expressed as standard deviations above or below the mean BMD of age and sex-matched normal subjects (Z-score), the difference in FN BMD between fractured women and controls was highly significant (-0.6 +/- 0.1 v. +0.1 +/- 0.1, P less than 0.001). As compared with mean BMD of young normal subjects, BMD was decreased by 36.9 +/- 1.4 and 22.4 +/- 1.5% (P less than 0.001) in fractured and control women, respectively. There was no significant difference between FN BMD of 33 women with cervical and 24 with trochanteric hip fractures (0.603 +/- 0.017 v. 0.577 +/- 0.020). FN BMD was lower than 0.705 g/cm2 in 90% of fractured women.(ABSTRACT TRUNCATED AT 250 WORDS)

Citing Articles

Unravelling novel and pleiotropic genes for cannon bone circumference and bone mineral density in Yorkshire pigs.

Qiu Z, Cai W, Liu Q, Liu K, Liu C, Yang H J Anim Sci. 2024; 102.

PMID: 38330300 PMC: 10914368. DOI: 10.1093/jas/skae036.

Identification of novel variants and candidate genes associated with porcine bone mineral density using genome-wide association study.

Nan J, Yin L, Tang Z, Xiang T, Ma G, Li X J Anim Sci. 2020; 98(4).

PMID: 32055823 PMC: 7166125. DOI: 10.1093/jas/skaa052.

Do we need orthogeriatrics in Poland? Changes in the age structure and location of hip fractures.

Wilk R, Skrzypek M, Kowalska M, Kusz D, Koczy B, Zagorski P Aging Clin Exp Res. 2016; 29(4):737-743.

PMID: 27600284 PMC: 5533813. DOI: 10.1007/s40520-016-0627-1.

Subgroup variations in bone mineral density response to zoledronic acid after hip fracture.

Magaziner J, Orwig D, Lyles K, Nordsletten L, Boonen S, Adachi J J Bone Miner Res. 2014; 29(12):2545-51.

PMID: 24839241 PMC: 4307640. DOI: 10.1002/jbmr.2283.

The initiative on hip fractures of the Veneto Region.

Rossini M, Caimmi C, Giannini S, Sella S, Mattarei A, Lovato R Clin Cases Miner Bone Metab. 2012; 9(1):45-9.

PMID: 22783336 PMC: 3392679.

References

Tinetti M, Speechley M, Ginter S . Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988; 319(26):1701-7. DOI: 10.1056/NEJM198812293192604. View

Dalen N, Hellstrom L, Jacobson B . Bone mineral content and mechanical strength of the femoral neck. Acta Orthop Scand. 1976; 47(5):503-8. DOI: 10.3109/17453677608988728. View

Delmi M, Rapin C, BENGOA J, Delmas P, VASEY H, Bonjour J . Dietary supplementation in elderly patients with fractured neck of the femur. Lancet. 1990; 335(8696):1013-6. DOI: 10.1016/0140-6736(90)91073-j. View

Bohr H, Schaadt O . Bone mineral content of femoral bone and the lumbar spine measured in women with fracture of the femoral neck by dual photon absorptiometry. Clin Orthop Relat Res. 1983; (179):240-5. View

Cummings S, Kelsey J, Nevitt M, ODowd K . Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985; 7:178-208. DOI: 10.1093/oxfordjournals.epirev.a036281. View

Riggs B, Wahner H, Seeman E, Offord K, Dunn W, Mazess R . Changes in bone mineral density of the proximal femur and spine with aging. Differences between the postmenopausal and senile osteoporosis syndromes. J Clin Invest. 1982; 70(4):716-23. PMC: 370279. DOI: 10.1172/jci110667. View

Cooper C, McLaren M, Wood P, Coulton L, Kanis J . Indices of calcium metabolism in women with hip fractures. Bone Miner. 1989; 5(2):193-200. DOI: 10.1016/0169-6009(89)90096-2. View

Hui S, Slemenda C, JOHNSTON Jr C . Baseline measurement of bone mass predicts fracture in white women. Ann Intern Med. 1989; 111(5):355-61. DOI: 10.7326/0003-4819-111-5-355. View

Slosman D, Rizzoli R, Buchs B, Piana F, Donath A, Bonjour J . Comparative study of the performances of X-ray and gadolinium 153 bone densitometers at the level of the spine, femoral neck and femoral shaft. Eur J Nucl Med. 1990; 17(1-2):3-9. DOI: 10.1007/BF00819396. View

10.

Wootton R, Brereton P, Clark M, Hesp R, Hodkinson H, Klenerman L . Fractured neck of femur in the elderly: an attempt to identify patients at risk. Clin Sci (Lond). 1979; 57(1):93-101. DOI: 10.1042/cs0570093. View

11.

Mazess R, BARDEN H, Ettinger M, Schultz E . Bone density of the radius, spine, and proximal femur in osteoporosis. J Bone Miner Res. 1988; 3(1):13-8. DOI: 10.1002/jbmr.5650030104. View

12.

Norimatsu H, Mori S, Uesato T, Yoshikawa T, Katsuyama N . Bone mineral density of the spine and proximal femur in normal and osteoporotic subjects in Japan. Bone Miner. 1989; 5(2):213-22. DOI: 10.1016/0169-6009(89)90098-6. View

13.

Hosking D . Changes in serum alkaline phosphatase after femoral fractures. J Bone Joint Surg Br. 1978; 60(1):61-5. DOI: 10.1302/0301-620X.60B1.627581. View

14.

Cummings S . Are patients with hip fractures more osteoporotic? Review of the evidence. Am J Med. 1985; 78(3):487-94. DOI: 10.1016/0002-9343(85)90343-2. View

15.

Mautalen C, Vega E, Ghiringhelli G, FROMM G . Bone diminution of osteoporotic females at different skeletal sites. Calcif Tissue Int. 1990; 46(4):217-21. DOI: 10.1007/BF02554998. View

16.

Riggs B, Melton 3rd L . Involutional osteoporosis. N Engl J Med. 1986; 314(26):1676-86. DOI: 10.1056/NEJM198606263142605. View

17.

Aniansson A, Zetterberg C, Hedberg M, Henriksson K . Impaired muscle function with aging. A background factor in the incidence of fractures of the proximal end of the femur. Clin Orthop Relat Res. 1984; (191):193-201. View

18.

Ray W, Griffin M, Schaffner W, Baugh D, Melton 3rd L . Psychotropic drug use and the risk of hip fracture. N Engl J Med. 1987; 316(7):363-9. DOI: 10.1056/NEJM198702123160702. View

19.

Eriksson S, Widhe T . Bone mass in women with hip fracture. Acta Orthop Scand. 1988; 59(1):19-23. DOI: 10.3109/17453678809149337. View

20.

Esses S, Lotz J, Hayes W . Biomechanical properties of the proximal femur determined in vitro by single-energy quantitative computed tomography. J Bone Miner Res. 1989; 4(5):715-22. DOI: 10.1002/jbmr.5650040510. View