Bone mineral density in patients with femoral neck fractures

Ortop Traumatol Rehabil. 2006 Aug 31;8(4):395-401.

Abstract

Background: [corrected] By providing essential information regarding bone mineral density (BMD), Densitometry can predict the mechanical resistance of bone tissue and the risk of fractures. However, fractures frequently occur in the femoral cervix and the spine before the loss of BMD reaches the densitometric threshold of osteoporosis.

Material and methods: We studied 46 patients with total hip arthroplasty subsequent to femoral cervix fracture, divided into three age groups: 80. All subjects underwent densitometry of the unaffected hip and the spine. BMD was also measured in slices of resected bone taken from various points.

Results: 80.4% of the patients with fractures were women. The BMD of the femoral cervix and the lumbar spine is lower in women regardless of age. Even though the men in the 70-79 age bracket had the highest BMD in both places, their T-score for the femoral cervix indicated osteoporosis; as did that of all subjects in the 80+ age group. The remaining patients should be diagnosed with osteopenia. The in vitro results were similar.

Conclusions: The lower average BMD in all women points to a significantly higher risk of fracture. Reduced BMD indicates risk but is not a certain predictor of fracture. This may result from uneven distribution of bone density in the femoral cervix. The fact that lower BMD was found in slices from the anterior and inferior regions of the femoral cervix, lying on the axis of greatest distortion during a fall, may support this hypothesis.