RISK OF HIP FRACTURE IN WOMEN WITH VERTEBRAL FRACTURE

In a population-based retrospective cohort study, Rochester women aged 35-69 years who were first diagnosed with one or more vertebral fract ures in 1950-1979 were followed for the development of a subsequent hi p fracture. The 336 women with no history of hip fracture at the time of their vertebral fracture experienced 52 proximal femur fractures in 4788 person-years of follow-up. The standardized morbidity ratio (SMR ) of observed to expected hip fractures was 1.8 (95% CI, 1.3-2.4) and was higher for intertrochanteric than cervical femoral fractures (SMR, 2.3 versus 1.3; P = 0.07). Hip fracture risk among women with symptom atic vertebral fractures was slightly less than in those with asymptom atic vertebral fractures (SMR, 1.8 versus 2.3; not significant), and y ounger women had no higher risk of a subsequent hip fracture than wome n who were greater than or equal to 60 years of age at the time of the ir vertebral fracture (SMR, 1.4 versus 1.8; not significant). Alternat ive explanations are possible, but these data are consistent with hete rogeneity in the pathogenesis of different osteoporotic fractures.