Localized femoral BMD T-scores according to the fracture site of hip and the evaluation of the sensitivity of the high risk group designated by FRAX® in hip fracture patients

ObjectivesIn hip fracture patients, studies about relevance between localized proximal femoral bone mineral density (BMD) and the fracture sites of hip are very rare. We compared T-scores of each femoral neck and trochanteric portion in a femoral neck fracture patients group (NFP) and in an intertrochanteric fracture patients group (IFP). Our hypothesis is that the T-score of neck portion is lower than the T-score of trochanteric portion in NFP and vice versa. We evaluated how the FRAX® probability is meaningful in hip fracture patients.Methods180 hip fracture patients were included and evaluated by BMD. We compared the average of T-scores between neck and trochanteric portion in each group. Differences between the regional T-score of neck and trochanteric portion were calculated in each patient and compared between two groups. We calculated the FRAX® probability in each patient and compared between two groups.ResultsFor the two groups, the average of the T-scores in neck portion was lower than the T-scores in trochanteric portion. In NFP, the average of difference between the regional BMD of neck portion and trochanteric portion was greater than that of IFP. FRAX® probability of hip fracture in NFP was higher than that in IFP. 77.3% of NFP and 80.8% of IFP were classified as high risk group for hip fracture.ConclusionThe localized femoral BMD data supports that localized femoral T-scores are relevant to the fracture sites of the hip. The high risk group designated by FRAX® is a sensitive tool to evaluate hip fractures in osteoporotic patients.