title: Hip fracture patients have more vertebral deformities than subjects in population-based studies.
abstract: The prevalence of vertebral deformity, estimated in lateral spine radiographs (Th4-L4) using quantitative morphometry, in 64 men and 132 women with hip fractures was compared with the prevalence of vertebral deformity in individuals in two population-based studies. A vertebral deformity of a specific vertebra was defined as a 3, 4, or 5 SD reduction from the normal mean of any of three ratios describing that specific vertebra. The age-adjusted prevalence of individuals with vertebral deformities was higher among the hip fracture patients than among the reference subjects in both genders, with an odds ratio of 3.6 [95% confidence interval (CI) 1.9-6.6] in men and 2.6 (95% CI 1.7-4.1) in women using deformity criterion -3 SD. Also, the number of vertebrae with deformities (-3 SD) in individuals with one deformity or more was greater among the hip fracture patients than among the reference subjects (in men mean 2.3 versus 1.8, P = 0.007; in women mean 3.3 versus 2.0, P < 0.001). Adjusted for age there were more vertebrae with deformities (-3 SD) among female than among male hip fracture patients (mean 3.3 versus 2.3, P = 0.01). We found no differences in the vertebral deformity rates when comparing patients with a per- or subtrochanteric hip fracture with patients with a cervical hip fracture. In conclusion, there is a relationship between vertebral deformities and hip fractures suggesting that a prevalent vertebral deformity could predict an increased hip fracture risk.
authors.affiliation: Department of Orthopaedics, Malmö University Hospital, Malmö, Sweden. ralph.hasserius@skane.se
authors.forename: R
authors.initials: R
authors.lastname: Hasserius
authors.forename: O
authors.initials: O
authors.lastname: Johnell
authors.forename: B E
authors.initials: BE
authors.lastname: Nilsson
authors.forename: K-G
authors.initials: KG
authors.lastname: Thorngren
authors.forename: K
authors.initials: K
authors.lastname: Jonsson
authors.forename: D
authors.initials: D
authors.lastname: Mellström
authors.forename: I
authors.initials: I
authors.lastname: Redlund-Johnell
authors.forename: M K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011859:Radiography; D012307:Risk Factors; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric