J Korean Fract Soc.  2007 Jul;20(3):222-226. 10.12671/jkfs.2007.20.3.222.

Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture

• Moon SH
• Suh BH
• Kim DJ
• Kong GM
• Cho HG

• KMID: 2296821
• DOI: http://doi.org/10.12671/jkfs.2007.20.3.222

Abstract

PURPOSE
To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture.
MATERIALS AND METHODS
57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically.
RESULTS
Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05).
CONCLUSION
BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.

Keyword

Femur; Intertrochanteric fracture; Bone mineral density; Lumbar

MeSH Terms

Absorptiometry, Photon
Aged*
Bone Density*
Female
Femur
Femur Neck
Humans
Lumbar Vertebrae
Male
Middle Aged
Osteoporotic Fractures

Reference

1. Boyd HB, Griffin LL. Classification and treatment of trochanteric fractures. Arch Surg. 1949; 58:853–866.

2. Cameron JR, Sorenson J. Measurement of bone mineral in vivo; an improved method. Science. 1963; 142:230–232.

3. Choi JS, An KC, Lee CS, Choi JM, Kim JY, Shin DR. DEXA T-score concordance and discordance between hip and lumbar spine. J Korean Soc Spine Surg. 2003; 10:75–81.

4. Cummings SR, Kelsey JL, Nevitt MC, O . 'Dowd KJ: Epidemiology of osteoporotic fractures. Epidemiol Rev. 1985; 7:178–208.

5. Ebbesen EN, Thomsen JS, Beck-Nielsen H, Nepper-Rasmussen HJ, Mosekilde L. Age- and gender-related differences in vertebral bone mass, density, and strength. J Bone Miner Res. 1999; 14:1394–1403.

6. Jahng JS, Yoo JH, Sohn JS. The relationship between the fractures of the hip and the bone mineral density over fifty years. J Korean Orthop Assoc. 1997; 32:46–52.

7. Kong GM, Lee SE, Kim DJ, Yoon TH. Differances of bone mineral density between spine and hip in osteoporotic patients. J Korean Fract Soc. 2005; 18:181–184.

8. Lee KS, Lee IH, Woo KJ, Park JH, Wie DG. Biomechanical study about difference between stainless steel and titanium dynamic hip screws in peritrochanteric fractures of the femur. J Korean Orthop Assoc. 1997; 32:929–936.

9. Melton LJ 3rd, Wahner HW, Richelson LS, O'Fallon WM. Osteoporosis and the risk of hip fracture. Am J Epidemiol. 1986; 124:254–261.

10. Rha JD, Park HS, Park YB, Lim CS, Kim SW. The importance of position of the distal fragment in intertrochanteric fracture of the femur using compression hip screw. J Korean Soc Fract. 2003; 16:447–455.

11. Riggs BL, Melton LJ. Evidence for two distinct syndromes of involutional osteoporosis. Am J Med. 1983; 75:899–901.

12. Riggs BL, Melton LJ 3rd. Involutional osteoporosis. N Engl J Med. 1986; 314:1676–1686.

13. Riggs BL, Wahner HW, Melton LJ 3rd, Richelson LS, Judd HL, Offord KP. Rates of bone loss in the appendicular and axial skeletons of women. Evidence of substantial vertebral bone loss before menopause. J Clin Invest. 1986; 77:1487–1491.

14. Sarkar S, Reginster JY, Crans GG, Diez-Perez A, Pinette KV, Delmas PD. Relationship between changes in biochemical markers of bone turnover and BMD to predict vertebral fracture risk. J Bone Miner Res. 2004; 19:394–401.

15. Sinaki M, Limburg PJ, Wollan PC, Rogers JW, Murtaugh PA. Correlation of trunk muscle strength with age in children 5 to 18 years old. Mayo Clin Proc. 1996; 71:1047–1054.