Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Orthop. Dec 18, 2012; 3(12): 235-238
Published online Dec 18, 2012. doi: 10.5312/wjo.v3.i12.235
Do osteoporosis-related vertebral fractures precede hip fractures?
Mir Sadat-Ali, Abid Hussain Gullenpet, Md Quamar Azam, Ammar K Al-Omran
Mir Sadat-Ali, Md Quamar Azam, Ammar K Al-Omran, Department of Orthopaedic Surgery, College of Medicine, University of Dammam and King Fahd Hospital of the University, Al Khobar 31952, Saudi Arabia
Abid Hussain Gullenpet, Department of Radiology, College of Medicine, University of Dammam and King Fahd Hospital of the University, Al Khobar 31952, Saudi Arabia
Author contributions: All the authors contributed to this article.
Correspondence to: Mir Sadat-Ali, MBBS, MS, FRCS, Professor, Department of Orthopaedic Surgery, College of Medicine, PO box 40071, King Fahd University Hospital, AlKhobar 31952, Saudi Arabia. drsadat@hotmail.com
Telephone: +966-50-5848281 Fax: +966-3-8820887
Received: June 1, 2012
Revised: November 16, 2012
Accepted: December 6, 2012
Published online: December 18, 2012
Abstract

AIM: To evaluate the relationship between a vertebral fracture and a hip fracture in Saudi Arabians with osteoporosis.

METHODS: In this retrospective study, 154 Saudi Arabian patients with osteoporosis-related hip fractures were analyzed for the presence of a vertebral fracture. Radiographs were retrieved from the IPAC (Image Picture Archiving and Computing) System, an imaging retrieval system, and were reviewed independently by two of the authors, Abid Hussain Gullenpet, and Mir Sadat-Ali, and later reviewed jointly. Patients admitted with proximal hip fracture who were ≥ 50 years and had undergone Thoraco-lumber imaging and a dual energy X-ray absorptiometry (DEXA) scan were included in the study. Patients with a history of significant trauma to the spine and those with a malignancy or connective tissue disorder were excluded from the analysis.

RESULTS: Out of 154 patients with hip fractures, 78 had a fracture of the femoral neck while 76 had an intertrochanteric hip fracture. Of the 111 patients who were finally included in the study, after applying inclusion and exclusion criteria, 76 patients with an average age of 67.28 ± 12 years had no fractures of the spine. Thirty-five patients with an average age of 76.9 ± 14.5 years (31.53%) had a total of 49 vertebral fractures. Patients with vertebral fractures were significantly older than those without fractures P < 0.001. Overall, 24.7% of these patients had an asymptomatic vertebral fracture. Further analysis showed that 11 males (18.96%) and 24 females (45.28%) had suffered a previous asymptomatic vertebral fracture. Interestingly, all women who participated in this study and who presented with a femoral neck fracture had experienced a prior asymptomatic vertebral fracture.

CONCLUSION: We recommend that all elderly patients who go to the radiology department for a chest X-ray also have a DEXA scan and a lateral thoracic spine radiograph.

Keywords: Fragility fracture, Osteoporosis, Vertebral fractures, Hip fractures, Saudi Arabia