F. Duboeuf et al., DIFFERENT MORPHOMETRIC AND DENSITOMETRIC PARAMETERS PREDICT CERVICAL AND TROCHANTERIC HIP FRACTURE - THE EPIDOS STUDY, Journal of bone and mineral research, 12(11), 1997, pp. 1895-1902
We used an experimental software measuring the hip axis length (HAL) a
nd bone mineral density (BMD) in specific regions of the lower and upp
er part of the femoral neck on dual-energy X-ray absorptiometry scans,
To determine whether these parameters were significant predictors of
the type of hip fracture, we measured 167 healthy women (controls), 24
women with trochanteric, and 42 women with cervical hip fractures wit
hin the EPIDOS prospective cohort, EPIDOS is a multicenter prospective
study on risk factors for hip fracture performed in 7575 elderly wome
n living at home, aged 75-95 and conducted in five French centers (Ami
ens, I;yon, Montpellier, Paris, Toulouse), Measurements were performed
on data acquired at baseline before the occurrence of fracture, In th
e cervical fracture group, HAL was significantly longer than in contro
ls (94.2 vs, 92.3, p = 0.03), and the associated odds ratio (OR) adjus
ted for age, weight, and total femoral neck BMD was significant (OR =
1.64, 95% confidence interval [CI] 1.06-2.55), In contrast, HAL was no
t significantly different from controls in the trochanteric fracture g
roup, Femoral neck diameter,vas not a predictor of fracture, The upper
and lo,ver femoral neck BMD was lower in the trochanteric fracture gr
oup than in controls, and both measurements predicted trochanteric fem
oral neck fracture, In contrast, the prediction of cervical femoral ne
ck fracture was enhanced by measuring only the upper part of the femor
al neck (OR = 2.79 vs, 1.97 for the total femoral neck) while BMD of t
he lower part was not different from controls, Hip axis length is a pr
edictor of femoral neck fracture, Femoral neck BMD distribution is dif
ferent between cervical and trochanteric fractures, These results supp
ort the hypothesis of a different pathophysiological mechanism between
the two types of hip fractures.