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Background: Fragility fracture significantly increases risk of future fracture. The fragility fracture cycle should be disrupted. The secondary fracture prevention is important for the patients with fragility hip fracture. The pharmacotherapy for osteoporosis is important for prevention of new fracture. However, many patients with hip fracture do not receive osteoporosis treatment. This retrospective study investigates the influence of bone mineral density (BMD) assessment on the initiation of anti-osteoporosis medications in the hospitalized patients with fragility hip fracture., Methods: This retrospective research enrolled 1211 patients with fragility hip fracture 50 years of age and older. Among 1211 patients aged from 50 to 103 years with the average age of 77.83 ± 9.95 years, there were 807 females and 404 males. There were 634 fractures of femoral neck and 577 intertrochanteric fractures of femur. We examined whether patients had received bone mineral density assessment and received anti-osteoporosis therapy during the period of hospitalization. The patients were divided into BMD assessment group and no BMD assessment group. Measurement data were expressed as mean ± standard deviation and compared with t test. All parameters of groups were compared with Chi-square test., Results: Of 1211 patients, 331 (27.33%) had received BMD assessment and 925 (76.38%) had received anti-osteoporosis drugs during the period of hospitalization. The rate of bisphosphonate use was lower and only 11.31% in the total patients. The anti-osteoporosis treatment rate was 93.66% in the patients receiving BMD assessment and 69.89% in the patients without BMD assessment (p < 0.01). The zoledronate use significantly increased from 6.7% in the patients without BMD assessment to 23.56% in the patients receiving BMD assessment (p < 0.01)., Conclusions: BMD assessment is a good basis for communication between patients and orthopedic surgeons. BMD assessment significantly increases the initiation of osteoporosis treatment and bisphosphonate use in the patients with hip fracture during the period of hospitalization.

Background: This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures., Methods: One hundred and seventeen patients were divided into femoral neck and trochanteric fracture groups. There were 69 patients with femoral neck fractures, 20 men and 49 women with an average age of 75.1 ± 9.6 years and an average body mass index (BMI) value of 21.6 ± 4.1 kg/m 2 . The trochanteric group consisted of 48 patients, 16 men and 32 women with an average age of 78.1 ± 9.1 years and an average BMI value of 21.5 ± 4.3 kg/m 2 . All patients underwent dual-energy X-ray absorptiometry (DXA) of the contralateral hip; hip structural analysis (HSA) software was used to analyze the femoral geometry parameters, including hip axis length (HAL), neck-shaft angle (NSA), cross-sectional area (CSA), the cross-sectional moment of inertia (CSMI), the buckling ratio (BR), and cortical thickness., Results: The cortical thickness in the intertrochanteric region was reduced in the trochanteric fractures group compared to the femoral neck fracture group (P < 0.05). There were no statistically significant differences (P > 0.05) in gender, age, height, weight, or BMI between the two groups. In addition, no statistically significant differences (P > 0.05) were found in the CSA, CSMI, or BR of the femoral neck or the intertrochanteric region between the two groups. There were no statistically significant differences (P > 0.05) in femoral neck cortical thickness between the two groups., Conclusions: Cortical thickness thinning in the intertrochanteric region may be one of the relevant factors causing different types of hip fractures, especially in elderly patients.

The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

Objective: The aim of this research is to study the effect of time factors on the mortality of brittle hip fracture., Methods: The data of 705 patients of hip fracture hospitalized at our department from 2010 to 2012 were reviewed. Among them, 499 cases undergoing surgical operation over the age of 50 were followed up, and 250 cases had valid follow-up records. The effects of the time from injury to operation, the time from injury to hospitalization and the time from hospitalization to operation on the mortality were analyzed., Results: The average duration of follow-up was 21.37 ± 9.77 months. There were 198 cases which were followed up for over 12 months. Nine patients died within 3 months after the hip fracture surgery, and 13 patients died within 1 year. A total of 25 patients died during the follow-up. The survival rate of patients with the interval from injury to surgery longer than 5 days was lower than that of patients with the interval less than or equal to 5 days (p = 0.014). The survival rate of patients with the interval from injury to hospitalization longer than 2 days was lower than that of patients with the interval from injury to hospitalization less than or equal to 2 days (p = 0.003). There was no statistical significance in the survival rate between patients with the interval from hospitalization to surgery longer than 3 days and that of patients with the interval from hospitalization to surgery less than or equal to 3 days (p = 0.973)., Conclusion: The operational delay, especially the delay of time from injury to hospitalization, is an important factor affecting the early mortality of hip fracture. The delay of time from hospitalization to operation is mainly due to the consideration of the patients' situation and has no effect on early mortality.

Background: This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures.Methods: One hundred and seventeen patients were divided into femoral neck and trochanteric fracture groups. There were 69 patients with femoral neck fractures, 20 men and 49 women with an average age of 75.1 ± 9.6 years and an average body mass index (BMI) value of 21.6 ± 4.1 kg/m2. The trochanteric group consisted of 48 patients, 16 men and 32 women with an average age of 78.1 ± 9.1 years and an average BMI value of 21.5 ± 4.3 kg/m2. All patients underwent dual-energy X-ray absorptiometry (DXA) of the contralateral hip; hip structural analysis (HSA) software was used to analyze the femoral geometry parameters, including hip axis length (HAL), neck-shaft angle (NSA), cross-sectional area (CSA), the cross-sectional moment of inertia (CSMI), the buckling ratio (BR), and cortical thickness.Results: The cortical thickness in the intertrochanteric region was reduced in the trochanteric fractures group compared to the femoral neck fracture group (P < 0.05). There were no statistically significant differences (P > 0.05) in gender, age, height, weight, or BMI between the two groups. In addition, no statistically significant differences (P > 0.05) were found in the CSA, CSMI, or BR of the femoral neck or the intertrochanteric region between the two groups. There were no statistically significant differences (P > 0.05) in femoral neck cortical thickness between the two groups.Conclusions: Cortical thickness thinning in the intertrochanteric region may be one of the relevant factors causing different types of hip fractures, especially in elderly patients. [ABSTRACT FROM AUTHOR]