title: Bone mineral density aspects in the femoral neck of hip fracture patients.
abstract: Elderly people, due to neurological conditions and muscular atrophy, present a greater propensity to falls and thus are very susceptible to hip fractures. Other variables, such as osteoporosis, may also be related to the etiopathogenesis of hip fractures, although osteoporosis is in fact a concurrent disease, and merely a coadjutant cause. Nonetheless, osteoporosis can make fracture patterns more severe and interfere with osteosynthesis. Osteoporosis is the radiological image of osteopenia, a pathological concept meaning a smaller quantity of bone per unit of volume. The radiological expression of osteopenia is therefore that of bone tissue with a lower radiological density than normal. In the context of hip fractures, bone mineral density and bone architecture of the femoral neck together with protein expression profiles and cross-links of this anatomical area are of special interest which is reviewed in the current paper. Spatial variations in bone mineral density in the femoral neck were found in the literature with increased porosity from the periosteal to the endosteal region and also from the distal to the proximal part of the femoral neck. Furthermore, increased crystal size, increased cortical porosity, reduced osteocyte lacunar density and an increased Ca/P ratio associated with higher concentrations of Ca and P were described in hip fracture patients compared to control patients. Osteocalcin/collagen type 1 expression ratio and enzymatic cross-link content in high-density bone was found to be significantly lower in hip fractures compared to controls. In conclusion, further research in bone mineral density and associated parameters are of interest to deepen the understanding of osteoporotic hip fractures.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology. Hospital Universitario Costa del Sol. University of Malaga. Marbella, Malaga. Spain. Electronic address: eguerado@hcs.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Guerado
authors.affiliation: Department of Orthopaedic Surgery and Traumatology. Hospital Universitario Costa del Sol. University of Malaga. Marbella, Malaga. Spain.
authors.forename: Encarnacion
authors.initials: E
authors.lastname: Cruz
authors.affiliation: Department of Orthopaedic Surgery and Traumatology. Hospital Universitario Costa del Sol. University of Malaga. Marbella, Malaga. Spain.
authors.forename: Juan Ramon
authors.initials: JR
authors.lastname: Cano
authors.affiliation: Tissue Engineering Group. Department of Histology. University of Granada. Granada. Spain.
authors.forename: Pascual Vicente
authors.initials: PV
authors.lastname: Crespo
authors.affiliation: Tissue Engineering Group. Department of Histology. University of Granada. Granada. Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Alaminos
authors.affiliation: Tissue Engineering Group. Department of Histology. University of Granada. Granada. Spain.
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: Sánchez-Quevedo
authors.affiliation: Tissue Engineering Group. Department of Histology. University of Granada. Granada. Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Campos
mesh_terms: D000058:Accidental Falls; D015519:Bone Density; D002118:Calcium / Q000378:metabolism; D024042:Collagen Type I / Q000378:metabolism; D005272:Femur Neck / Q000378:metabolism* / Q000473:pathology; D006620:Hip Fractures / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D015675:Osteocalcin / Q000378:metabolism; D010024:Osteoporosis / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D058866:Osteoporotic Fractures / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D010758:Phosphorus / Q000378:metabolism; D012307:Risk Factors
chemical_list: D024042:Collagen Type I; D015675:Osteocalcin; D010758:Phosphorus; D002118:Calcium
keywords: Mineralization; Osteoporosis; bone density; bone metabolism; calcium; hip fracture; phosphorus