Disease relevance of Hip Fractures

• Hypogonadism contributes to bone loss in 20-30% of elderly men, and in both sexes hyperparathyroidism secondary to calcium malabsorption increases remodelling, worsening the cortical thinning and porosity and predisposing to hip fractures [1].
• The purpose of this study is to evaluate the effectiveness of risedronate sodium, an inhibitor of bone resorption, on osteoporosis and the risk of hip fractures in men 65 years or older after stroke [2].
• The clinical course was favorable in all patients who stopped fluoride, although 5 patients who continued the treatment had either completion of femoral neck stress fractures to hip fractures (n = 2), or recurrent stress fractures (n = 2), or both (n = 1) [3].
• Vitamin D deficiency is common in the elderly and may lead to secondary hyperparathyroidism, cortical bone loss, and hip fractures [4].
• Bone fracture occurred more often in H1R-only treated patients (30.19%) than in controls (chi(2) p=0.01); however, clinical vertebral or hip fractures developed neither in those treated only with H1R antagonist nor in those who received both H1R antagonist and inhaled corticosteroid [5].

Psychiatry related information on Hip Fractures

• After adjusting for history of falls and diagnosis of dementia, subjects with an APOE 4 allele were still twice as likely to report hip fractures (adjusted OR = 2.1, 95% CI: 0.9 - 4.7) [6].
• We explored the role of iron overload, deficiency of vitamin C and alcohol abuse in the aetiology of cervical and intertrochanteric fractures of the neck of the femur as a result of minor trauma [7].

High impact information on Hip Fractures

• Calcium and vitamin D supplements reduce this secondary hyperparathyroidism, but whether such supplements reduce the risk of hip fractures among elderly people is not known [8].
• Vitamin D3 and calcium to prevent hip fractures in the elderly women [8].
• Vitamin A intake and hip fractures among postmenopausal women [9].
• CONCLUSIONS: Long-term intake of a diet high in retinol may promote the development of osteoporotic hip fractures in women [9].
• HMG-CoA reductase inhibitors and the risk of hip fractures in elderly patients [10].

Chemical compound and disease context of Hip Fractures

• RESULTS: Women with hip fractures had lower levels of 25-hydroxyvitamin D than women without osteoporosis admitted for elective joint replacement (P = .02) and than women with osteoporosis admitted for elective joint replacement (P = .01) (medians, 32.4, 49.9, and 55.0 nmol/L, respectively; comparisons adjusted for age and estrogen intake) [11].
• Spontaneous hip fractures in fluoride-treated patients: potential causative factors [12].
• Two rigorously conducted studies provide credible evidence that the bisphosphonate alendronate reduces the risk of vertebral and hip fractures by approximately 40-50% [13].
• CONCLUSION: Treatment with risedronate increases bone mineral density and reduces hip fractures in elderly men who are poststroke [2].
• However, neither raloxifene therapy nor calcitonin therapy reduce the risk of nonvertebral and hip fractures at currently approved doses [14].

Biological context of Hip Fractures

• To examine the possible role of circulating estrogen or androgen levels in the development of this type of fracture, 25 patients with hip fractures after minimal trauma were compared to an equal number of controls, matched for age and years since menopause [15].
• Recently, erythropoietin therapy has been shown to stimulate hematopoiesis in patients with hip fractures [16].
• However, carefully monitored treatment with warfarin with Thrombotest always less than 0.20, appeared to be the most effective prophylaxis in patients with hip fractures [17].

Anatomical context of Hip Fractures

• Combined lumbar and sacral plexus block compared with plain bupivacaine spinal anesthesia for hip fractures in the elderly [18].
• Serial measurements of C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were performed during the week after operation in 140 patients with hip fractures [19].

Gene context of Hip Fractures

• In contrast, in hip fractures, immunoreactivity to MMP-1, 2, 3, and 9 was weak and only observed in synovial tissues [20].
• A subgroup of 32 women who were found to have vertebral fractures, hip fractures, or both had significantly higher values for serum BGP than the remainder [21].
• Increased bone resorption, low serum estradiol and high serum sex-hormone-binding globulin (SHBG) recently have been reported as predictors of vertebral and hip fractures in elderly women [22].
• Protein-energy malnutrition, which is common in elderly patients with osteoporotic hip fractures, is associated with reduced plasma levels of insulin-like growth factor-I (IGF-I) [23].
• Elderly women with hip fractures exhibit an increased RANKL/OPG mRNA content of iliac bone [24].

Analytical, diagnostic and therapeutic context of Hip Fractures

• Recent studies of patients with hip fractures from two hospitals have suggested that the marked reduction in length of stay that occurred following implementation of the Medicare prospective payment system (PPS) resulted in decreased quality of care for these patients [25].
• RESULTS: After adjustment for multiple factors, including age, body mass index, and estrogen use, we found a trend toward fewer hip fractures (relative hazards [RHs], 0.19-0.62) and, to a lesser extent, nonspine fractures (RHs, 0.49-0.95) among statin users in each of the 4 prospective studies [26].
• Hip fractures may be too infrequent to evaluate in practical clinical trials; even the Multiple Outcomes of Raloxifene Evaluation (MORE) study with 7,705 subjects was insufficiently powered to show a comparable reduction in hip fractures [27].
• Meta-analysis of the efficacy of alendronate for the prevention of hip fractures in postmenopausal women [28].
• Surgical repair of hip fractures using continuous spinal anesthesia: comparison of hypobaric solutions of tetracaine and bupivacaine [29].

References