Predictor of hip fracture type: a systematic review

Predictor of hip fracture type: a systematic review

Authors

  • Maria Rosaria Matrangolo
  • Alessandro Smimmo
  • Raffaele Vitiello Università Cattolica del Sacro Cuore Roma
  • Andrea De Fazio
  • Alessandro El Motassime
  • Giovanni Noia
  • Felice Minutillo
  • Giulio Maccauro

Keywords:

Hip fracture, Femoral Neck Fracture, Pertrochanteric fracture, Proximal femoral fracture, BMD, Vitamin D, PTH, Hip osteoarthritis

Abstract

BACKGROUND & AIM

In literature, many risk factors have been related to proximal femur fracture, but most of the studies do not explore differences between femoral neck fractures (FNF) and pertrochanteric fractures (PF). The aim of the paper is to review the current literature n order to assess risk factors associated with a specific pattern of proximal femur fracture.

 

METHODS

Nineteen studies met the inclusion criteria and were taken into consideration in the review. Data reported from the included articles were age, gender of the patient, type of femoral fracture, BMI, height, weight, soft tissue composition, BMD, vitamin D levels, PTH levels, hip morphology and hip osteoarthritis.

 

RESULTS

Bone mineral density (BMD) of the intertochanteric region result significant lower in PF, while BMD in femoral neck regione was lower in FNF. Low levels of Vit D with high PTH are observed in TF whereas low levels of vit D and normal PTH in FNF. Hip osteoarthritis (HOA) is significant less present and less severe in FNF, while in PF is usually more frequent or higher grade.

 

CONCLUSIONS

Patients with pertrochanteric fracture are older, with a low cortical thickness in the femoral isthmus, low BMD in the intertrochanteric region, severe HOA, low mean haemoglobin and albumin levels and hypovitaminosis D with a high PTH levels. Patients with FNF are younger, taller, with higher body fat mass, with lower BMD levels in femoral neck region, mild HOA, hypovitaminosis D without PTH response.

References

Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury.2018;49(8):1458–60.

Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet Lond Engl.2019;393(10169):364–76.

Bäcker HC, Wu CH, Maniglio M, Wittekindt S, Hardt S, Perka C. Epidemiology of proximal femoral fractures. J Clin Orthop Trauma. 2021;12(1):161–5.

Piscitelli P, Feola M, Rao C, et al. Incidence and costs of hip fractures in elderly Italian popula-tion: first regional-based assessment. Arch Osteoporos. 2019;14(1):81.

Williamson S, Landeiro F, McConnell T, et al. Costs of fragility hip fractures globally: a systematic review and meta-regression analysis. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA. 2017;28(10):2791–800.

Simunovic N, Devereaux PJ, Sprague S, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. Can Med Assoc J. 2010;182(15):1609–16.

Dyer SM, Crotty M, Fairhall N, et al. A critical review of the long-term disability out-comes following hip fracture. BMC Geriatr. 2016;16:158.

Hannan EL, Magaziner J, Wang JJ, et al. Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA. 2001;285(21):2736–42.

Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD. Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma. 1997;11(3):162–5.

Dahl E. Mortality and life expectancy after hip fractures. Acta Orthop Scand. 1980;51(1):163–70.

Pioli G, Barone A, Giusti A et al. Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res. 2006;18(5):381–7.

Vitiello R, Perisano C, Covino M, et al. Euthyroid sick syndrome in hip fractures: Valuation of vit-amin D and parathyroid hormone axis. Injury. 2020;51 Suppl 3.

M C, R V, C P, et al. Euthyroid sick syndrome in hip fractures: Evaluation of postoperative anemia. Injury. 2020;51 Suppl 3:S9–12.

Vitiello R, Ziranu A, Oliva MS, et al. The value of megaprostheses in non-oncological fractures in elderly patients: A short-term results. Injury. 2021;S0020-1383(21)00800-7.

Covino M, Vitiello R, De Matteis G, et al. Hip Fracture Risk in Elderly with Non-End-Stage Chronic Kidney Disease: A Fall Related Analysis. Am J Med Sci. 2021;S0002-9629(21)00249-4.

Thorngren K-G. Fractures of the Femoral Neck and Proximal Femur. In: Bentley G, curatore. European Surgical Orthopaedics and Traumatology: The EFORT Textbook [Internet]. Berlin, Heidelberg: Springer; 2014 [citato 15 novembre 2021]. pag. 2203–68. Disponibile su: https://doi.org/10.1007/978-3-642-34746-7_14

Sircana G, Cauteruccio M, Oliva MS, et al. Fibrin sealant reduces need for transfusions after hip hemiarthroplasty for femoral neck fractures. Injury. 2020;51 Suppl 3:S23–7.

Basilico M, Vitiello R, Oliva MS, et al. Predictable risk factors for infections in proximal femur fractures. J Biol Regul Homeost Agents. 2020;34(3 Suppl. 2):77–81.

Cauley JA, Lui L-Y, Genant HK, et al. Risk factors for severity and type of the hip fracture. J Bone Miner Res Off J Am Soc Bone Miner Res. 2009;24(5):943–55.

Karres J, Heesakkers NA, Ultee JM, Vrouenraets BC. Predicting 30-day mortality following hip fracture surgery: Evaluation of six risk prediction models. Injury. 2015;46(2):371–7.

Cazzato G, Masci G, Liuzza F et al. Secondary femur fracture following treatment with ante-rograde nailing: the state of the art. J Biol Regul Homeost Agents. 2018;32(6 Suppl. 1):151–5.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

Tanner DA, Kloseck M, Crilly RG, Chesworth B, Gilliland J. Hip fracture types in men and women change differently with age. BMC Geriatr. 2010;10:12.

Cho Y, Lee I, Ha SH, Park JH, Park JH. Comparison of hip subregion bone mineral density to the type of proximal femur frac-ture. Arch Osteoporos. 2020;15(1):122.

Di Monaco M, Vallero F, Di Monaco R, Mautino F, Cavanna A. Body composition and hip fracture type in elderly women. Clin Rheumatol. 2004;23(1):6–10.

Di Monaco M, Vallero F, Di Monaco R, Tappero R, Cavanna A. Type of hip fracture in patients with Parkinson disease is associ-ated with femoral bone mineral density. Arch Phys Med Rehabil. 2008;89(12):2297–301.

Dretakis K, Igoumenou VG. The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type. Aging Clin Exp Res [Internet]. 30 gennaio 2019 [citato 14 aprile 2019]; Disponibile su: http://link.springer.com/10.1007/s40520-019-01132-7

Fisher A, Srikusalanukul W, Davis M, Smith P. Hip fracture type: Important role of parathyroid hormone (PTH) response to hypovitaminosis D. Bone. 2010;47(2):400–7.

Mautalen CA, Vega EM, Einhorn TA. Are the etiologies of cervical and trochanteric hip fractures different? Bone;18(3 Suppl):133S-137S.

Michaëlsson K, Weiderpass E, Farahmand BY, et al. Differences in risk factor patterns between cervical and trochanteric hip fractures. Swedish Hip Fracture Study Group. Osteoporos Int J Establ Result Coop Eur Found Os-teoporos Natl Osteoporos Found USA. 1999;10(6):487–94.

Nakamura N, Kyou T, Takaoka K, Ohzono K, Ono K. Bone mineral density in the proximal femur and hip fracture type in the el-derly. J Bone Miner Res Off J Am Soc Bone Miner Res. 1992;7(7):755–9.

Treece GM, Gee AH, Tonkin C, et al. Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study. J Bone Miner Res Off J Am Soc Bone Miner Res. 2015;30(11):2067–77.

Zhuang H, Li Y, Lin J, et al. Cortical thickness in the intertrochanteric region may be relevant to hip frac-ture type. BMC Musculoskelet Disord. 2017;18(1):305.

Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC. Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res Off J Am Soc Bone Miner Res. 1994;9(12):1889–94.

Bruce DG, St John A, Nicklason F, Goldswain PR. Secondary hyperparathyroidism in patients from Western Australia with hip fracture: relationship to type of hip fracture, renal function, and vitamin D deficiency. J Am Geriatr Soc. 1999;47(3):354–9.

Maeda Y, Sugano N, Saito M, Yonenobu K. Comparison of femoral morphology and bone mineral density between femoral neck fractures and trochanteric fractures. Clin Orthop. 2011;469(3):884–9.

Calderazzi F, Groppi G, Ricotta A, Ceccarelli F. Does hip osteoarthritis have a protective effect against proximal femoral fractures? A retrospective study. Hip Int J Clin Exp Res Hip Pathol Ther. 2014;24(3):231–6.

Aguado-Maestro I, Panteli M, García-Alonso M, García-Cepeda I, Giannoudis PV. Hip osteoarthritis as a predictor of the frac-ture pattern in proximal femur fractures. Injury. 2017;48 Suppl 7:S41–6.

Maluta T, Toso G, Negri S, Samaila EM, Magnan B. Correlation between hip osteoarthritis and proximal femoral fracture site: could it be protective for intracapsular neck fractures? A retrospective study on 320 cases. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA. 2019;30(8):1591–6.

Rotem G, Sharfman ZT, Rath E, et al. Does hip morphology correlate with proximal femoral fracture type? Hip Int J Clin Exp Res Hip Pathol Ther. 2020;30(5):629–34.

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Published

23-06-2023

How to Cite

1.
Matrangolo MR, Smimmo A, Vitiello R, De Fazio A, El Motassime A, Noia G, et al. Predictor of hip fracture type: a systematic review. Acta Biomed [Internet]. 2023 Jun. 23 [cited 2024 Jul. 23];94(S2):e2023047. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12572