Risk factors for femoral neck fracture in elderly population / 中南大学学报(医学版)

OBJECTIVES@#To explore the risk factors for femoral neck fracture in elderly population.@*METHODS@#A total of 124 elderly patients (≥60 years old) in hospital for trauma were enrolled, including 71 patients (57%) with femoral neck fracture and 53 non-femoral neck fracture patients (43%). All patients' age, gender, body mass index (BMI), bone mineral density (BMD), thigh length and average circumference were collected. Single factor analysis and multivariate logistic regression analysis were performed to explore whether the above factors were risk factors for femoral neck fracture.@*RESULTS@#Single factor analysis showed that the age, gender, BMI, BMD, thigh length, and average thigh circumference between the 2 groups were statistically different (all @*CONCLUSIONS@#Older age, female, lower BMI index (low body weight), lower BMD (osteoporosis), longer thigh length, and lower average circumference are risk factors for femoral neck fracture in the elderly population.

Influencia de la polución ambiental en la incidencia de fractura de cuello femoral / Influence of enviromental pollution on the femoral neck fracture incidence

It has been shown that there is an association between air pollution and cardiovascular mortality. In bone pathology, studies show that air pollution is associated with a risk of developing osteoporosis and osteoporotic fracture associated with MP2.5 and nitrogen dioxide (NO2 ). The aim of our study was to determine whether or not there is an association between air pollution and osteoporotic disease, associating the incidence of femoral neck fracture in individuals aged 50 years or more and the contamination present in the several cities. Our results showed no statistically significant association between air pollution, evaluated using PM10 and PM2.5 as indicators, and the average annual incidence of osteoporotic hip fracture, comparing the most polluted cities and the less polluted cities of Chile

The Effect of FRAX on the Prediction of Osteoporotic Fractures in Urban Middle-aged and Elderly Healthy Chinese Adults

OBJECTIVE: We aimed to analyze the applicability of a fracture risk assessment tool for the prediction of osteoporotic fractures in middle-aged and elderly healthy Chinese adults. METHODS: A standard questionnaire was administered, and bone mineral density was measured in residents visiting the Dongliu Street Community Health Service Center. Paired t-tests were used to compare the FRAX-based probabilities of fractures estimated with and without consideration of bone mineral density. Risk stratification and partial correlation analyses were applied to analyze the associations between FRAX-based probabilities and body mass index or bone mineral density at different sites. RESULTS: A total of 444 subjects were included in this study. Of these subjects, 175 (39.59%) were diagnosed as osteoporotic, and 208 (47.06%) were diagnosed as osteopenic. The Kappa value for the detection of osteoporosis at the L1-L4 lumbar spine and femoral neck was 0.314. The FRAX-based 10-year major osteoporotic fracture probability and hip osteoporotic fracture probability estimated without considering bone mineral density were 4.93% and 1.64%, respectively; when estimated while considering bone mineral density, these probabilities were 4.97% and 1.54%, respectively. A significant positive association was observed between the FRAX-based fracture probabilities estimated with and without consideration of bone mineral density, while significant negative associations between body mass index and the estimated FRAX-based fracture probabilities after adjustment for age and the estimated FRAX-based fracture probabilities and femoral neck bone mineral density were identified. These results remained the same after controlling for lumbar spine bone mineral density. CONCLUSIONS: The Chinese FRAX model could predict osteoporotic fracture risk regardless of whether bone mineral density was considered and was especially appropriate for predicting osteoporotic fractures of the femoral neck.

Fratura espontânea do colo do fêmur após retirada de PFN / Spontaneous fracture of the femoral neck following PFN removal

A fratura do colo femoral, sem trauma associado, após a consolidação da fratura transtrocantérica é um evento raro. Os autores relatam um caso de fratura transtrocantérica tratada com PFN, que duas semanas após a retirada da síntese, apresentou fratura do colo femoral, que foi tratada com artroplastia parcial.

Femoral neck fracture without associated trauma following consolidation of a transtrochanteric fractureis a rare event. The authors report a case of transtrochanteric fracture that was treated with PFN and which presented fracturing of the femoral neck two weeks after removal of the device. This occurrence was treated with partial arthroplasty.

Simultaneous fracture of both femoral necks secondary to a hypocalcemic seizure

We report a rare case of simultaneous fracture of both femoral necks caused by hypocalcemic fit secondary to chronic renal failure. The case was successfully treated by bilateral bipolar arthroplasties

Fracturas vertebrales, osteoporosis y vitamina D en la posmenopausia: Estudio en 555 mujeres en Chile / Vertebral fractures, osteoporosis and vitamin D levels in Chilean postmenopausal women

Background: Approximately one-third of vertebral fractures can be clinically diagnosed. Aim: To study the frequency of vertebral fractures in postmenopausal women. Patients and methods: We recruited 555 postmenopausal women from Santiago, Chile, aged 55-84 years, who manifested interest in their bone health. All were healthy by self-declaration and by general clinical and laboratory tests and had not taken any bone-active therapy. They all underwent a spine and femoral neck (FN) densitometry and a digital lateral spine X-ray from T4 to L4 was obtained. PTH, calcidiol, and other parameters of calcium metabolism were also measured. Results: Overall, 142 of 478 patients with a complete study (29.7 percent) had at least one vertebral fracture. The proportion of women with fractures increased with age. A T score below -2.5 in the spine and hip was found in 32 percent and 14 percent of women, respectively. The proportion of women with spinal opeoporosis doubled between ages 55-70 and remained constant afterwards. In contrast, at the femoral neck, this proportion increased progressively reaching 53.3 percent at age 80-85. However, 56 percent of patients with vertebral fractures did not have densitometric osteoporosis in any location. Calcidiol levels were 16.8±6.8 ng/mL. With a cutoff point of 17 ng/mL, 47.5 percent of the patients had hypovitaminosis D. There was no association between calcidiol levels and vertebral fractures or bone density at the spine or femoral neck. Patients with fractures differed from those without fractures in that they had significantly lower bone density at the spine and hip and were older (p <0.001). However they did not differ in weight, body mass index, or calcidiol levels. Conclusions: Thirty percent of postmenopausal women in this series had a vertebral fractures. Osteoporosis and vitamin D deficiency were also common. Most vertebral fractures were observed in women without osteoporosis by densitometric criteria.

5 years experience in intracapsular femoral neck fracture management

Displaced intracapsular fracture of the femoral neck remain a challenging issue despite the advancement in the ways of treatment. The purpose of this study is to assess the results of different methods of treatment in different age groups. This study was conducted over a period from [1998-2004] on 26 patients, with ages of 5 - 85 years with intracapsular fracture of the femoral neck due to different insults in Tikrit teaching hospital. Open reduction and internal fixation was done to those patients of <60 years of age, while uncemented Austin-Moore hemiarthroplasty was conducted in patients of >60 years old. Patients were followed for 6-12 months for any complication. The main age group among the patients were those >60 years [13 [50%]]. The main cause of fracture was fall from standing position in 19 [73%], were treated by uncemented Austin-Moore prostheses. The main complications were hip and knee pain [8[30.7%] and 5 [19.2%]] respectively. Non-union [11.5%] and avascular necrosis [11.5%] was the commonest complications in young patients, and were treated by internal fixation especially if the time of surgery was delayed over 24 hours. The reduction and internal fixation will continue to be used as the primary treatment of displaced intracapsular fracture in many younger patients because the benefits of preservation of the normal hip joint which should be done urgently within the first 24 hours. However, if this method of treatment is unsuccessful and requires revision, the risk of early complications is higher and hip function is poor. When hemiarthroplasty is the treatment of choice cemented fixation is preferable

[Stress fracture of femoral neck [Report of 3 observations]]

Authors bring back 5 cases of fractures of stress of the femoral collar respectively at 3 patient aged of 26, 36 and 47 years with bilateral reach in 2 cases. The diagnosis of stress fracture has kept before a bundle of arguments to know: the traumatic absence and the existence of an obvious intense physical activity in case, the pathological antecedent absence, the normality of the biologic balance well as the reminiscent radiological aspect. The treatment consisted in a vissage in 4 cases total arthroplastie of the hip in a case. To the light of these 3 observations and a magazie of the literature, authors analyze epidemiologic, etiopathogenic and physiopathologic aspects aspects as well as the therapeutic possibilities of the fractures of stress of the femoral collar. They also underline especially the gravity of this pathology and the interest of data of the imagery to the precocious stadiums of the illness the scintigraphie and the IRM, the key of the treatment being the precocious

Bilateral simultaneous hip fractures secondary to an epileptic seizure

A 30-year-old man sustained bilateral simultaneous displaced subcapital fractures of neck of femur during an epileptic tonic-clonic seizure. After admission to the hospital approximately 18 hours later, internal fixation of the fractures with dynamic hip screw was undertaken. Post operatively, he was managed by early motion and weight bearing on the second day. Despite the severity of the fractures and delayed surgery, satisfactory union of the fractures was noted at 6 months when bone densitometry was normal. At 3 years follow up, there was no sign of avascular necrosis of the femoral heads

Prise en charge des fractures du col femoral : a propos d'une serie de 84 cas (CHU de Yopougon)

Dans notre memoire; nous rapportons la prise en charge de 84 fractures du col femoral au CHU de Yopougon.Ce travail a ete realise sur une periode de 6 ans (1993-1998). L'age moyen etait de 64 ans (extremes 16 et 88 ans). L'etiologie etait dominee par une chute de leur hauteur pour les patients ages; alors que l'accident de la voie publique etait la cause essentielle chez le sujet jeune.72 patients soit 85;71pour cent des cas ont ete operes; 10 patients soit 11;09pour cent ont eu un traitement orthopedique; 2 sont decedes au cours du bilan.62 patients ont ete revus avec un recul moyen de 3 ans; on notait 14 deces et 8 perdus de vue.Nos resultats fonctionnels apprecies par la cotation de Merle d'Aubigne etaient satisfaisants a 88pour cent pour le traitement chirurgical et 59pour cent pour le traitement orthopedique

Tratamiento de las fracturas del cuello del fémur / Proccessing of the fractures of the neck of fémur

Se analiza retrospectivamente los ingresos al Hospital Carlos Andrade Marín con diagnóstico de fracturas de cuello femoral, predominando el sexo femenino (n=48, 71,64 por ciento) sobre el masculino (n=19, 28,35 por ciento). El rango de edad es amplio, desde los 21 años hasta los 91 años. La etiología de la fractura fue un trauma de baja energía (caída de propia altura) en 59 individuos (88 por ciento) y trauma de alta energía (atropellamiento, n=4, 5,9 por ciento; caída de más de dos metros de altura, n=4, 5,9 por ciento). Respecto al tratamiento, un número importante de casos requirió el uso de prótesis (n=47, 70,1 por ciento) mientras que los casos restantes se emplearon clavos de Ender (n=5, 7,4 por ciento)...

Incidencia de fractura de cuello de femur (FCF): área sur y sur oriente de Santiago / Incidence of femoral collar fracture in the souther area of Santiago Chile

La Osteoporosis ha emergido como verdadera epidemia. Su principal consecuencia es el aumento de fracturas en los ancianos. Con el fin de conocer las tasas de incidencia de la fractura más grave, la de cuello de fémur, se revisaron los egresos de los Hospitales Barros Luco-Trudeau y Sótero del Río. En una población de 1.582.823 beneficiarios, se encontraron, en los años 1984 y 1985, 312 casos, lo que da una tasa de incidencia de 9.8 pacientes por 100.000 habitantes por año. Los mayores de 45 años tenían una tasa de 45 comparada con 1,1 de los individuos menores. Las mujeres presentan 1,5 veces más Fracturas de Cuello de Fémur que los hombres. En mayores de 45 años las tasas aumentan constantemente con la edad. Comparadas con tasas inglesas, las chilenas tienen 1/6 y los hombres 1/3 de FCF. Concluimos que la FCF es propia de los individuos mayores, preferentemente de sexo femenino. Comparada con tasas inglesas nuestras tasas son significativamente menores

Fracturas del cuello del femur en los ninos / Fractures of the neck of the femur in children

Se revisa la experiencia obtenida en el tratamiento de las fracturas del extremo proximal del femur en los ninos. Se analizaron las historias clinicas y los estudios radiologicos de 43 casos tratados en el Hospital Universitario Pediatrico de La Misericordia de Bogota, en los ultimos 20 anos y 5 casos, tratados y controlados personalmente por el autor desde julio de 1982 hasta julio de 1987. Se siguio la clasificacion establecida por Delbet, en 4 grupos: Tipo I transepifisiarias: 3 casos (6.25%); Tipo II Transcervicales: 17 casos (35.41%); Tipo III cervico-trocantericas: 18 casos (37.5%); Tipo IV Intertrocantericas: 10 casos (20.83%). Los resultados obtenidos se analizaron, siguiendo los criterios establecidos por Ratliff y en general, se consideran similares a los encontrados por la mayoria de los autores que se han ocupado de este tema. La frecuencia con que se presentan estas fracturas, continua siendo baja (aproximadamente 2.5 por ano) lo cual aun hace valida la premisa establecida por Blount en 1955, segun la cual "las verdaderas fracturas del extremo proximal del femur son tan raras que nadie tiene suficiente experiencia con ellas". Los metodos de tratamiento no se han modificado significativamente con el transcurso de los anos y la aparicion de la necrosis osea avascular, la gran responsable de los malos resultados, se encuentra relacionada principalmente con el grado de desplazamiento inicial de las fracturas.