Vertebral fractures as a precursor to potential hip fractures in elderly women

Abstract Objective: The purpose of this study was to investigate the kind of low-energy fracture which is a precursor of hip fracture in the elderly, and to suggest the importance of osteoporosis treatment and gait training for fall prevention after this low-energy fracture to prevent the occurrence of secondary hip fracture. Methods: From January 2017 to December 2020, a total of 564 patients who underwent surgical treatment for hip fractures were admitted to the Zhongda Hospital affiliated to Southeast University. Baseline information including gender, age, diagnosis and type of low-energy fracture before hip fracture were collected. FRAX score, the number of patients received functional training and the number of patients received anti-osteoporosis treatment were analyzed. Results: There were180 male patients and 384 female patients in the total 564 patients. The number of male patients with low-energy fractures before hip fracture was 28, including hip fracture (8 cases), vertebral fracture (8 cases) and humeral fracture (7 cases), and radial fracture (5 cases). The number of female hip fracture patients with a low-energy fracture before fracture was 62, containing vertebral fracture (31 cases), hip fracture (15 cases), radial fracture (9 cases) and humeral fracture (7 cases). It was found that vertebral fractures were the most frequent low-energy fractures that preceded hip fractures in elderly women compared to other low-energy fractures. It was showed that the 10-year probability of hip fracture and other site fractures was significantly higher in the group with lumbar fractures and other site fractures than those in the group without fractures assessed by using the FRAX measurement system. There were no statistical significance among the three groups of patients who underwent functional training and anti-osteoporosis treatment. We could not find statistical significance among the three groups of patients who underwent functional training and anti-osteoporosis treatment. Conclusion: Vertebral fracture is a precursor of hip fracture in elderly women. In face of the vertebral fractures, surgeons, especially orthopedic surgeons, should pay extra attention to the treatment of osteoporosis and anti-fall functional training.