Evaluation of vertebral hidden fractures in patients with proximal femoral fractures

Abstract

Objective: To evaluate the Spine Deformity Index (SDI) and serum levels of vitamin D in patients surgically treated for proximal femur fracture and its relationship with osteoporosis. Methods: Between August and November 2013, patients older than 50 years-old with surgical fracture of the proximal femur by low-energy trauma underwent radiographic evaluation of the spine and the vitamin D levels, and enquired about diagnoses and previous treatment of osteoporosis. Results: Sixty-six patients met the inclusion criteria. The mean age was 78 years; the average level of vitamin D was 19 ng/mL. The SDI ranged between zero and 25, with a mean of 8.2. Eighty percent of these patients had never been treated for osteoporosis. Of the patients analyzed, 89.3% had insufficient levels of vitamin D. Of these, 68.1% had also SDI above 5, and only one fifth of them had any treatment for osteoporosis. Statistical significance was found between age and levels of vitamin D as well as age and SDI. Gender was not predictive of the vitamin D levels or the amount of hidden spine fractures. The season of the year had no direct influence on vitamin D levels. Conclusions: Hospitalized patients with surgical fractures of the proximal femur had a higher SDI associated with vitamin D insufficiency, with osteoporosis most often untreated, which results in delayed spinal fractures diagnosis of spinal fractures and increased risk of new fractures.

Conservative Treatment and Vitamin D Levels in Patients With Spinal Fractures

“…As for the presence of previous fractures, in our study, of the patients with acute osteoporosis fracture in the spine, two had a simultaneous hip fracture. According to the work of Sebben et al, 4 the literature already shows an important correlation between these fractures, which was also evidenced in Dawson-Hughes et al 27 An evaluation for a longer period and with a more significant number of patients is necessary to evaluate the morbidity, the mortality and understand how these fractures affect the quality of life of these patients in the long term, compared to surgical treatment.…”

“…3 The presence of a spine fracture is a risk factor for fractures in other regions of the skeleton and segments of the spine itself. 4 Some consequences of these fractures include pain, loss of sagittal balance, and functional limitation. 5 In Brazil, data on the prevalence of osteoporosis and the incidence of associated fractures are scarce.…”