Jean-Charles Aurégan1,2,3, Aurélien Frison4, Thierry Bégué4, Didier Hannouche5,6, Catherine Bosser7, Morad Bensidhoum5, Thierry Hoc7. 1. Department of Orthopedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140, Clamart, France. aureganjc@yahoo.fr. 2. Laboratory of Tribology and System Dynamics (LTDS - UMR CNRS 5513), Ecole Centrale Lyon, 36 avenue Guy de Collongues, 69134, Ecully, France. aureganjc@yahoo.fr. 3. Laboratory of Bioengineering and Bioimaging for Bone and Articulation (B2OA - UMR CNRS 7052), Paris-Diderot University, 10 avenue de Verdun, 75010, Paris, France. aureganjc@yahoo.fr. 4. Department of Orthopedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140, Clamart, France. 5. Laboratory of Bioengineering and Bioimaging for Bone and Articulation (B2OA - UMR CNRS 7052), Paris-Diderot University, 10 avenue de Verdun, 75010, Paris, France. 6. Department of Orthopedic Surgery and Traumatology, Lariboisière Hospital, AP-HP, Paris-Diderot University, 2 Rue Ambroise Paré, 75010, Paris, France. 7. Laboratory of Tribology and System Dynamics (LTDS - UMR CNRS 5513), Ecole Centrale Lyon, 36 avenue Guy de Collongues, 69134, Ecully, France.
Abstract
PURPOSE: A correlation between soft tissue thickness and osteoporosis has been suggested. We aimed to estimate if a low body mass index (BMI) and/or a decrease of skin thickness could estimate the risk of contra-lateral hip fracture. METHODS: First, we performed a retrospective analysis of 1268 patients treated for a hip fracture. The 146 patients who had a contra-lateral hip fractures-study group-were compared with the 1078 patients who did not-control group. Four BMI categories were considered: obese, overweight, normal weight and low weight. Second, we enrolled prospectively 1000 consecutive patients in the emergency department. History of fractures, BMI, and skin aspect on the dorsum of both hands-classified as severe decrease thickness, moderate decrease thickness or normal-were recorded. RESULTS: pt?>In the first part, we found that patients with contra-lateral fractures had a significantly lower BMI than those in the control group (22.2 Vs 26.5 kg/m2, p = 0.01). In the second part, 48 on 1000 patients had a hip fracture. Among them, six had a contra-lateral fracture. BMI was 23.4 kg/m2 in bilateral hip fractures, 33.68 kg/m2 in the unilateral fracture group, and 28.04 kg/m2 in the non-fracture group (p = 0.04). Finally, patients with contra-lateral hip fractures had a severe decrease thickness of the skin. CONCLUSION: A low BMI and a decreased skin thickness increase independently the risk of fractures by three times. When associated, they increase the risk of fracture risk by five times. This combination had a sensitivity at 71 % and a specificity at 90 % for predicting hip fracture.
PURPOSE: A correlation between soft tissue thickness and osteoporosis has been suggested. We aimed to estimate if a low body mass index (BMI) and/or a decrease of skin thickness could estimate the risk of contra-lateral hip fracture. METHODS: First, we performed a retrospective analysis of 1268 patients treated for a hip fracture. The 146 patients who had a contra-lateral hip fractures-study group-were compared with the 1078 patients who did not-control group. Four BMI categories were considered: obese, overweight, normal weight and low weight. Second, we enrolled prospectively 1000 consecutive patients in the emergency department. History of fractures, BMI, and skin aspect on the dorsum of both hands-classified as severe decrease thickness, moderate decrease thickness or normal-were recorded. RESULTS: pt?>In the first part, we found that patients with contra-lateral fractures had a significantly lower BMI than those in the control group (22.2 Vs 26.5 kg/m2, p = 0.01). In the second part, 48 on 1000 patients had a hip fracture. Among them, six had a contra-lateral fracture. BMI was 23.4 kg/m2 in bilateral hip fractures, 33.68 kg/m2 in the unilateral fracture group, and 28.04 kg/m2 in the non-fracture group (p = 0.04). Finally, patients with contra-lateral hip fractures had a severe decrease thickness of the skin. CONCLUSION: A low BMI and a decreased skin thickness increase independently the risk of fractures by three times. When associated, they increase the risk of fracture risk by five times. This combination had a sensitivity at 71 % and a specificity at 90 % for predicting hip fracture.
Entities:
Keywords:
Body mass index; Contra-lateral hip fracture; Skin thickness; Soft tissue thickness
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