Abstract
A prospective study of fractures of the femoral neck was conducted over 12 months in order to ascertain the relevance of generalised osteoporosis as determined by metacarpal morphometry. A series of some 200 women sustaining a fracture of the femoral neck after minor trauma had bone mass measurements similar to those of a control population of normal women, and 16% were not osteoporotic. A history of previous fractures was documented in one third of the women, but this was unrelated to the presence or severity of osteoporosis, although over half of the fractures had occurred within the previous four years. Trochanteric fractures were seen more commonly in severely osteoporotic women (p less than 0.005), whereas cervical fractures predominated in those who were not osteoporotic. These findings support the hypothesis that postural instability is the major determinant for femoral neck fracture and that generalised osteoporosis, rather than being a prerequisite for fracture, merely determines the type of fracture sustained.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aaron J. E., Gallagher J. C., Anderson J., Stasiak L., Longton E. B., Nordin B. E., Nicholson M. Frequency of osteomalacia and osteoporosis in fractures of the proximal femur. Lancet. 1974 Feb 16;1(7851):229–233. doi: 10.1016/s0140-6736(74)92545-8. [DOI] [PubMed] [Google Scholar]
- Aitken J. M., Smith C. B., Horton P. W., Clark D. L., Boyd J. F., Smith D. A. The interrelationships between bone mineral at different skeletal sites in male and female cadavera. J Bone Joint Surg Br. 1974 May;56(2):370–375. [PubMed] [Google Scholar]
- BARNETT E., NORDIN B. E. The radiological diagnosis of osteoporosis: a new approach. Clin Radiol. 1960 Jul;11:166–174. doi: 10.1016/s0009-9260(60)80012-8. [DOI] [PubMed] [Google Scholar]
- Boston D. A. Bilateral fractures of the femoral neck. Injury. 1982 Nov;14(3):207–210. doi: 10.1016/0020-1383(82)90132-2. [DOI] [PubMed] [Google Scholar]
- Gallagher J. C., Melton L. J., Riggs B. L., Bergstrath E. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res. 1980 Jul-Aug;(150):163–171. [PubMed] [Google Scholar]
- Horsman A., Gallagher J. C., Simpson M., Nordin B. E. Prospective trial of oestrogen and calcium in postmenopausal women. Br Med J. 1977 Sep 24;2(6090):789–792. doi: 10.1136/bmj.2.6090.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iskrant A. P., Smith R. W., Jr Osteoporosis in women 45 years and over related to subsequent fractures. Public Health Rep. 1969 Jan;84(1):33–38. [PMC free article] [PubMed] [Google Scholar]
- Lindsay R., Hart D. M., Aitken J. M., MacDonald E. B., Anderson J. B., Clarke A. C. Long-term prevention of postmenopausal osteoporosis by oestrogen. Evidence for an increased bone mass after delayed onset of oestrogen treatment. Lancet. 1976 May 15;1(7968):1038–1041. doi: 10.1016/s0140-6736(76)92217-0. [DOI] [PubMed] [Google Scholar]
- Melton L. J., 3rd, Ilstrup D. M., Riggs B. L., Beckenbaugh R. D. Fifty-year trend in hip fracture incidence. Clin Orthop Relat Res. 1982 Jan-Feb;(162):144–149. [PubMed] [Google Scholar]
- Nordin B. E. International patterns of osteoporosis. Clin Orthop Relat Res. 1966 Mar-Apr;45:17–30. [PubMed] [Google Scholar]
- Nordin B. E., MacGregor J., Smith D. A. The incidence of osteoporosis in normal women: its relation to age and the menopause. Q J Med. 1966 Jan;35(137):25–38. [PubMed] [Google Scholar]
- Owen R. A., Melton L. J., 3rd, Gallagher J. C., Riggs B. L. The national cost of acute care of hip fractures associated with osteoporosis. Clin Orthop Relat Res. 1980 Jul-Aug;(150):172–176. [PubMed] [Google Scholar]
- Riggs B. L., Seeman E., Hodgson S. F., Taves D. R., O'Fallon W. M. Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. Comparison with conventional therapy. N Engl J Med. 1982 Feb 25;306(8):446–450. doi: 10.1056/NEJM198202253060802. [DOI] [PubMed] [Google Scholar]
- STEVENS J., FREEMAN P. A., NORDIN B. E., BARNETT E. The incidence of osteoporosis in patients with femoral neck fracture. J Bone Joint Surg Br. 1962 Aug;44-B:520–527. doi: 10.1302/0301-620X.44B3.520. [DOI] [PubMed] [Google Scholar]
- Shimmins J., Anderson J. B., Smith D. A., Aitken M. The accuracy and reproducibility of bone mineral measurements in vivo'. (a) The measurement of metacarpal mineralisation using an x-ray generator. Clin Radiol. 1972 Jan;23(1):42–46. doi: 10.1016/s0009-9260(72)80133-8. [DOI] [PubMed] [Google Scholar]
- Smith D. A., Anderson J. B., Shimmins J., Speirs C. F., Barnett E. Changes in metacarpal mineral content and density in normal male and female subjects with age. Clin Radiol. 1969 Jan;20(1):23–31. doi: 10.1016/s0009-9260(69)80050-4. [DOI] [PubMed] [Google Scholar]
- Solomon L. Bone density in ageing Caucasian and African populations. Lancet. 1979 Dec 22;2(8156-8157):1326–1330. doi: 10.1016/s0140-6736(79)92813-7. [DOI] [PubMed] [Google Scholar]
- Solomon L. Osteoporosis and fracture of the femoral neck in the South African Bantu. J Bone Joint Surg Br. 1968 Feb;50(1):2–13. [PubMed] [Google Scholar]
- Wallace W. A. The increasing incidence of fractures of the proximal femur: an orthopaedic epidemic. Lancet. 1983 Jun 25;1(8339):1413–1414. doi: 10.1016/s0140-6736(83)92358-9. [DOI] [PubMed] [Google Scholar]