Proportion and Risk Factors of Silent Vertebral
Fractures Among Egyptian Females With Fragility Hip Fracture Presenting to the
Emergency Room of Ain Shams University Hospitals
Mohamed A. Abdelrahman Ali (1)
Hala S. Sweed (1)
Mohamed F. Allam (2)
Walaa W. Aly (1)
Abeer H. Mohamed Matter (1)
Walid E. Abdelalim Elshabrawy (3)
1. Geriatrics, Ain Shams University, Cairo, Egypt.
2. Family Medicine, Ain Shams University, Cairo, Egypt.
3. Orthopedic Surgery, Ain Shams University, Cairo, Egypt.
Cureus 15(9): e46214.
DOI: 10.7759/cureus.46214
Abstract
Background. Fragility fractures
caused by osteoporosis are known to increase the risk of further fragility
fractures. Also, several factors have been associated with an increasing
risk of fracture in postmenopausal women with osteoporosis, as prior
fracture, advancing age, low bone mineral density (BMD), greater risk or
history of falls certain, pharmacologic therapies such as
glucocorticoids, and medical conditions increase the risk of secondary
osteoporosis and related fractures through their direct impact on bone density
or structure. Menstrual history including age at menarche menopause and
a history of amenorrhea is documented as a predicting osteoporotic
fracture.
Objective. The aim of the current
study is to find the proportion of hidden vertebral fractures among Egyptian
females with fragility hip fracture.
Patients and methods. A cross-sectional study
was conducted on patients who presented to the orthopedic emergency room (ER)
of Ain Shams University Hospitals in Cairo, Egypt, from September 2020 to September
2021. Our inclusión criteria include females aged 40 years or older, who
presented to the ER with fragility hip fractures. A simple random sample of females
fulfilling our inclusión criteria for osteoporotic hip fracture was thoroughly investigated.
Conventional lateral and anteroposterior radiographs of the dorsolumbar spine
were obtained excluding those with high-impact fractures or pathological
fractures.
Results. During the study period,
a total of 43,935 persons presented to the orthopedic ER, of whom 30,901 were
females, comprising 70.03% of total orthopedic ER visits. A sample of 150
females met our inclusion criteria. Results showed that 16 of our 150 cases had
concomitant vertebral fracture, meaning that 10.7% of cases had hidden
vertebral fracture at the time of osteoporotic hip fracture, as diagnosed by
the screening lumbosacral plain X-rays. Older age at menarche, younger
age at menopause, and amenorrhea are shown to be risk factors for hidden
vertebral fracture in Egyptian females.
Conclusion. Osteoporosis is a complex and costly disease. Osteoporotic fractures may be largely preventable, as environmental factors are open to intervention, and effective pharmacological agents are available. Concomitant hidden vertebral fracture is prevalent among females with osteoporotic hip fractures, and those who had later menarche, earlier menopause, and menstrual irregularities have a higher incidence of developing associated vertebral fracture, which warrants identification and management to evade complications and mortality.
Keywords: elderly, vertebral fracture, osteoporosis, hip fracture, fragility fracture.
Abdelrahman Ali M A, Sweed H S, Allam M F, et al. (September 29, 2023) Proportion and Risk Factors of Silent Vertebral Fractures Among Egyptian Females With Fragility Hip Fracture Presenting to the Emergency Room of Ain Shams University Hospitals. Cureus 15(9): e46214.
