A histomorphometric study of osteomalacia in elderly females with fracture of the proximal femur.

Using standard histomorphometric indices on bone biopsies of trabecular bone volume, osteoid volume, the trabecular osteoid surface, the extent of the calcification front and the number of osteoid lamellae, a histomorphometric diagnosis of osteomalacia was made in three of 28 elderly female patients with fracture of the proximal femur. These patients also showed biochemical changes in the serum and deficiency of serum vitamin D. The 25 biopsies judged not to show osteomalacia showed a greater osteoid volume in the 12 patients who suffered an intertrochanteric fracture than in the 13 with a cervical fracture. Clinical biochemistry in these 25 patients showed considerable overlap between the normal range and that found in the patients with osteomalacic biopsies.