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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 15, Issue 3, July 2015 pp 436-441
To assess the prevalence of osteoporosis among elderly people presenting with hip fractures:
An observational study
Chander S G1, Subramaniam M H2, Narayana Reddy3
1Associate Professor, 2Assistant Professor, 3Professor and HOD, Department of Orthopaedics, Chettinad Hospital and Research Institute, IT Highway, Kelambakkam, Kanchipuram, Tamil Nadu, INDIA.
Introduction: Osteoporosis is a silently progressing metabolic bone disease that leads to gradual depletion of bone mass thereby making the bones fragile and increasing the tendency to fracture, even after a trivial fall. Osteoporosis is widely prevalent in India and osteoporotic fractures of hip are a common cause of morbidity and mortality in elderly Indian women and men. Vertebral compression fractures and fractures of the distal radius are two other common fractures due to osteoporosis in the elderly population. A review of the International pattern of osteoporosis reveals that “hip fractures” occur a decade earlier in Indians in comparison with the west. Old age, female sex, sedentary lifestyle, Calcium and vitamin D deficiency are common risk factors for osteoporosis. Aim: To assess the prevalence of Osteoporosis among elderly people presenting with hip fractures using Dexa scan of lumbar spine. Material and Methods: This prospective study is conducted in the Dept. of Orthopaedics, Chettinad Hospital and RI, IT Highway, Kelambakkam, Kanchipuram district, Tamilnadu. Elderly patients, presenting with newly sustained hip fracture, (Fractures of neck of femur, trochanter and sub-trochanteric region) would be selected for the study, based on the inclusion and exclusion criteria. This prospective study will be conducted for a period 24 months from October 2014 to September 2016. Patients admitted with hip fractures will undergo a DEXA SCAN of the lumbar spine, in the department of Radiology, CHRI. Patients who are found to be osteoporotic viz, T score of -2.5 or less, will then be treated with a single dose of bisphosphonate – Inj. Zoledronic acid 5mg IV infusion stat. Results: We are presenting the “Preliminary report” of this prospective study, assessing the Prevalence of Osteoporosis in the study group of first 52 patients, starting from October 2014 to June 2015. The Prevalence of Osteoporosis is 65.6% (34 patients out of 52). Sixteen patients (30.6%) had Osteopenia and two patients (3.8%) reported a normal dexa scan. Conclusion: Osteoporosis is an important risk factor for sustaining fractures of the hip in elderly people, following trivial falls. The high prevalence of osteoporosis in the study group could be due to the fact that more than 2/3 rds of the patients in the study group were females and about 50 out of 52 patients were in the age group of 61 years & above. Detection of osteoporosis at the time of admission for hip fracture and treatment with bis-phosphonate injection not only improves the bone mineral density at the time of fracture healing but also theoretically reduces the incidence of fractures of the contra-lateral hip in future. A larger sample size and a longer follow-up of the operated patients is required to substantiate the same.