Loss of bone in the proximal part of the femur following unstable fractures of the leg.

Wiel, H.E. van der; Lips, Paul; Nauta, J. J. P.; Patka, P.; Haarman, H. J. T. M.; Teule, G. J. J.

doi:10.2106/00004623-199402000-00009

Cited by 70 publications

(44 citation statements)

References 30 publications

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“…However, because the bone mass was lower in the hip fracture patients than in the controls only in the lower limbs but not in the upper limbs, it seems more likely that the reductions in the non-fractured limb are also an outcome of the fracture. This is further supported by previous studies that have shown that after a fracture aBMD decreases not only in the fractured but also in the non-fractured limb [8,[19][20][21]23] at a rate that is higher than the normal age-related decline [19,21]. In addition, aBMD may remain at a reduced level in the non-fractured limb at least five to six years after a lower limb fracture [20,22].…”

Section: Discussionsupporting

confidence: 81%

“…In the case of a lower limb fracture, the decline in aBMD seems to be steepest during the first 6 months following the injury [8,9,32]. During that time declines of 14% in the proximal tibia aBMD [9] and 19% in the proximal tibia vBMD [12] of the fractured limb have been reported to take place.…”

Section: Discussionmentioning

confidence: 99%

“…Bone mass declines in the affected limb after a fracture [8][9][10][11][12] and may result in a considerable side-to-side difference between the limbs [10,11,[13][14][15][16]. Part of this bone loss is thought to be caused by disuse of the affected limb following the injury [17].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies on posttraumatic bone loss have concentrated mainly on areal bone mineral density (aBMD) measured with a DXA scanner [8,9,14,15,[18][19][20][21][22][23]. Although the crosssectional geometry of bone has a large contribution to bone strength [24], the associations between lower limb fracture and bone geometry have been studied scarcely [25,26].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impaired geometric properties of tibia in older women with hip fracture history

et al. 2007

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impaired geometric properties of tibia in older women with hip fracture history

et al. 2007

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“…Previous studies also reported lower ultrasound measurement values in subjects with a history of fractures [21][22][23]. However, these results are hard to interpret since fractures may cause immobilization and consequently affect bone characteristics, especially in the fractured limb [18,19,24], and thus current measurements may not be related to values at the time of the fracture.…”

Section: Discussionmentioning

confidence: 77%

The Influence of Physical Activity and Fractures on Ultrasound Parameters in Elderly People

Graafmans

Bouter

Lips

1998

Osteoporosis International

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Abstract. In this cross-sectional study we investigated the relationship between ultrasound measurements in the calcaneus versus daily physical activity and fractures sustained in the past in elderly subjects. Ultrasound measurements were performed at both heels, which enabled us to examine determinants of differences between contralateral heels. Participants were 132 men and 578 women, aged 70 years and over (mean age and standard deviation (SD): 83 ± 6 years), living in homes for the elderly (n = 343) or apartment houses for the elderly (n = 367). Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured in the right and left calcaneus. The median difference (and interquartile range) between the two heels for BUA and SOS, expressed as a percentage of the mean value for each individual, was 9.6% (4.2-15.7%) and 1.0% (0.4-1.7%), corresponding to 25% and 40% of the study population SD, respectively. Greater differences in BUA between the two heels were associated with variables indicating poorer functional status, such as past fractures at the lower extremities. The level of daily physical activity was obtained by means of a questionnaire regarding household and leisure activities. Subsequently sumscores were calculated for daily physical activity and a subscore indicating weight-bearing physical activity. After adjustment for age, gender, residence, and body weight, physical activity scores were positively linearly related to both BUA and SOS. Each 5 point increase on the weight-bearing physical activity score, corresponding to, for example, walking for 2.5 h per week, was associated with a difference in BUA of 4.7 dB/MHz and in SOS of 5.1 m/s, which is similar to the differences associated with 10 kg higher body weight, or 10 years younger age. After the age of 50 years, 47 subjects had fractured a hip, 61 subjects had sustained another lower extremity fracture, 104 subjects a wrist fracture, and 62 subjects another upper extremity fracture. After adjusting for age, gender and residence, odds ratios for all fracture types in the lowest terciles of BUA and SOS versus the highest terciles ranged from 1.9 to 3.8. This study showed significant differences in ultrasound measurements between the left and the right heel, indicating that measurements at both sides are necessary for optimal evaluation of bone strength. Furthermore, after careful adjustments, ultrasound parameters had higher values with higher daily physical activity in elderly subjects and discriminated subjects with a history of fracture from those without.

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Effect of Teriparatide or Risedronate in Elderly Patients With a Recent Pertrochanteric Hip Fracture: Final Results of a 78-Week Randomized Clinical Trial

Malouf¹,

Tarantino

García-Hernández³

et al. 2016

Journal of Bone and Mineral Research

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We present final results of a study comparing teriparatide 20 mg every day (QD) with risedronate 35 mg once per week (QW) started within 2 weeks after surgery for a pertrochanteric hip fracture. Patients with BMD T-score -2.0 and 25OHD !9.2 ng/mL were randomized to receive 26-week double-dummy treatment plus calcium and vitamin D, followed by 52-week open-label treatment with the same assigned active drug. Primary endpoint was change from baseline in lumbar spine (LS) BMD at 78 weeks. Secondary and exploratory endpoints were change in BMD at the proximal femur, function, hip pain (Charnley score and 100 mm Visual Analog Scale [VAS]), quality of life (Short Form-36), radiology outcomes, and safety. Data were analyzed with mixed models for repeated measures (MMRM) and logistic regression. Totally, 224 patients were randomized; 171 (teriparatide: 86) contributed to the efficacy analyses (mean AE SD age: 77 AE 7.7 years, 77% females). Mean baseline LS, femoral neck (FN), and total hip (TH) T-scores were -2.16, -2.63, and -2.51, respectively. At 78 weeks, BMD increased significantly more with teriparatide compared to risedronate at the LS (þ11.08% versus þ6.45%; p < 0.001) and FN (þ1.96% versus -1.19%; p ¼ 0.003), with no significant between-group difference in TH BMD. Timed upand-go (TUG) test was significantly faster with teriparatide at 6, 12, 18, and 26 weeks (differences: -3.2 to -5.9 s; p ¼ 0.045 for overall difference). Hip pain during TUG test by 100 mm VAS was significantly lower with teriparatide at 18 weeks (adjusted difference: -11.3 mm, p ¼ 0.033; -10.0 and -9.3 mm at 12 and 26 weeks, respectively; p ¼ 0.079 for overall difference). Other secondary and exploratory outcomes were not different. Teriparatide group showed two new hip fractures versus seven with risedronate (p ¼ 0.171) and more frequent hypercalcemia and hyperuricemia. In conclusion, 78-week treatment with teriparatide showed significantly greater increases in LS and FN BMD, less pain, and a faster TUG test versus risedronate.

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Loss of bone in the proximal part of the femur following unstable fractures of the leg.

Cited by 70 publications

References 30 publications

Impaired geometric properties of tibia in older women with hip fracture history

Impaired geometric properties of tibia in older women with hip fracture history

The Influence of Physical Activity and Fractures on Ultrasound Parameters in Elderly People

Effect of Teriparatide or Risedronate in Elderly Patients With a Recent Pertrochanteric Hip Fracture: Final Results of a 78-Week Randomized Clinical Trial

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