Distribution of vertebral fractures varies among patients according to hip fracture type

• Published in: Osteoporosis international Vol. 26; no. 3; pp. 885 - 890
• Main Authors: Watt, J., Cox, L., Crilly, R. G.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.03.2015; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Endocrinology; Female; Femoral Neck Fractures - etiology; Fractures; Hip Fractures - etiology; Hip Fractures - pathology; Hip joint; Humans; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple Trauma - diagnostic imaging; Multiple Trauma - etiology; Multiple Trauma - pathology; Original Article; Orthopedics; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - etiology; Osteoporotic Fractures - pathology; Radiography; Retrospective Studies; Rheumatology; Spinal Fractures - diagnostic imaging; Spinal Fractures - etiology; Spinal Fractures - pathology; Studies; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Vertebrae; Vertebral fracture; Osteoporosis; Subcapital fracture; Intertrochanteric fracture
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-014-2887-y

Summary This study explored the distribution of vertebral fractures in hip fracture patients. Unlike patients with intertrochanteric fractures, those with subcapital fractures were less likely to have vertebral fractures in the T4-T10 region of the spine. The dissimilar distribution of vertebral fractures among patients with intertrochanteric and subcapital fractures may indicate different underlying etiologies. Introduction There are two main types of hip fractures: intertrochanteric and subcapital. Both types can have associated vertebral fractures. In this study, we explored the distribution of vertebral fractures in the two hip fracture populations. Methods This was a retrospective analysis of a convenience sample of 120 patients: 40 with subcapital fractures and vertebral fractures, 40 with intertrochanteric fractures and vertebral fractures, and 40 with vertebral fractures only. Based on Genant’s semiquantitative assessment method of radiographic images, the distribution and severity of each patient’s vertebral fractures were explored [ 1 ]. Results Patients with subcapital fractures had significantly fewer total vertebral fractures (93 vs. 144, p  = 0.005; 93 vs. 127, p  = 0.019), vertebral fractures from T4 to T10 (41 vs. 81, p  = 0.005; 41 vs. 64, p  = 0.042), and vertebral fractures at the T7-T8 peak (11 vs. 31, p  = 0.002; 11 vs. 30, p  = 0.003) than patients with intertrochanteric fractures and those with vertebral fractures alone, respectively, and they were more likely to have only one vertebral fracture (15 vs. 3, p  < 0.001; 15 vs. 2, p  < 0.001). The number of vertebral fractures from T11 to L4 and at the T12-L1 peak did not differ among the groups. The numbers of fractures at each vertebral level was significantly correlated only between those with intertrochanteric fractures and those with vertebral fractures alone ( r  = 0.65, p  = 0.009). Conclusion The distribution of vertebral fractures among patients with subcapital fractures differed from the other fracture groups, which may indicate that subcapital fractures and some lumbar fractures have a different underlying etiology than intertrochanteric fractures and thoracic (T4-T10) fractures.