Bone mineral density in fracture neck of femur patients: What's the significance?

Table 1 Osteoporosis risk factors utilised in Fracture Risk Assessment Tool predictive tool for osteoporotic fractures[29]

Clinical risk factors
Age
Gender
Weight
Height
Previous fracture
Parent fractured hip
Current smoking
Glucocorticoid use
Rheumatoid arthritis
Secondary osteoporosis risk factors — Type I diabetes mellitus, osteogenesis imperfecta, hyperthyroidism, hypogonadism, premature menopause, chronic malnutrition or malabsorption, chronic liver failure
Alcohol — 3 or more units per day
Bone mineral density

Table 2 World Health Organisation classification of osteoporosis[29]

Terminology	T-score definition
Normal	T ≥ -1.0
Osteopenia	-2.5 < T < -1.0
Osteoporosis	T ≤ -2.5
Severe osteoporosis	T ≤ -2.5 in the presence of one or more fragility fracture

Table 3 Patient demographic data

Patient demographic
Number of patients (n)	69
Age yr (mean, range)	74.1 (61-98)
Height cm (mean, range)	161.9 (141-190)
Weight kg (mean, range)	67.7 (31-150)
BMI (mean, range)	25.7 (16-63)
Gender (male:female)	25:44
Menopause age (mean, range)	46.6 (32-56)
Laterality (left:right)	27:42

BMI: Body mass index.

Table 4 Pattern of fracture neck of femur

	n (%)
Intra-capsular fracture	36 (52.2)
Extra-capsular fracture	33 (47.8)

Table 5 Surgical management of fracture neck of femur

	n (%)
Total hip replacement	24 (34.8)
Hemi-arthroplasty	10 (14.5)
Dynamic hip screw	31 (45.0)
Intra-medullary nail	4 (5.7)

Table 6 Dual-energy X-ray absorptiometry scan results

Dual-energy X-ray absorptiometry scan
FRAX major (mean ± SD)	19.87 ± 11.01
FRAX hip (mean ± SD)	7.75 ± 8.09
BMD hip (mean ± SD)	0.62 ± 0.13
T-score hip (mean ± SD)	-2.20 ± 1.05
z-score hip (mean ± SD)	-0.60 ± 0.97
BMD spine (mean ± SD)	0.88 ± 0.30
T-score spine (mean ± SD)	-1.36 ± 1.65
z-score spine (mean ± SD)	0.37 ± 1.72

BMD: Bone mineral density; FRAX: Fracture Risk Assessment Tool.

Table 7 Comparison of mean bone mineral density femoral neck and lumbar spine in males and females

	Male (n = 25)	Female (n = 44)	P value1
BMD femoral neck	0.65	0.61	0.364
BMD lumbar spine	1.01	0.85	0.135

¹Mann Whitney U test. BMD: Bone mineral density.

Table 8 Analysis between World Health Organization classification of femoral neck bone mineral density and mean menopause age of female patients (n = 39)

	n	Menopause age (mean ± SD)	P value1
Normal	5	45.0 ± 7.4	0.086
Osteopenia	16	44.8 ± 5.1
Severe osteoporosis	18	48.4 ± 5.1

¹Kruskal-Wallis H test.

Table 9 Analysis between World Health Organization classification of lumbar spine bone mineral density and mean menopause age of female patients (n = 40)

	n	Menopause age (mean ± SD)	P value1
Normal	15	47.2 ± 5.7	0.835
Osteopenia	15	46.1 ± 5.3
Severe osteoporosis	10	46.3 ± 6.1

¹Kruskal-Wallis H test.

Table 10 Analysis between World Health Organization classification of femoral neck bone mineral density and the pattern of fracture neck of femur (n = 62)

	Intra-capsular (n)	Extra-capsular (n)	P value1
Normal	6	2	0.026
Osteopenia	17	7
Severe osteoporosis	10	20

¹Chi-Squared test.