| Objective: To evaluate the value of bone mineral density(BMD)measurement by dual-energy X-ray absorptiometry(DXA)scanning method in predicting the risk of hip osteoporotic fracture in the elderly.Methods:Subject of this retrospective study were 38 cases patients with hip fracture in the first affiliated hospital of Dalian medical university from June 2014 to December 2017.Among them,29 cases of femoral neck fracture,with average age of(70.6 ± 10.1)years old.9 cases of intertrochanteric fractures,with average age of(74.3 ± 7.1)years old.All of them were injuried with low-energy trauma.In the same time,33 cases without fractures were selected as the control group with average age of(69.5 ± 8.9)years old.BMD of healthy hip(including femoral neck,intertrochanter,Ward area,total hip regions)and lumbar spine were measured by DXA method.BMD of left hip and lumbar spine were measured in the control group.Results: 1.The BMD of femoral neck,intertrochanter,Ward area,total hip,and lumbar vertebra in fracture group were significantly lower than those in control group(p <0.05).2.Between femoral neck fracture and intertrochanteric fracture group,the BMD including femoral neck,intertrochanter,Ward area,total hip regions and lumbar vertebra were not significantly different between the two groups(p> 0.05).3.The BMD of the femoral neck,intertrochanter and total hip regions in the fracture group was decrease 25.1%,25.1%,24.7% respectively than the control group.The most decrease in Word area was 37.5%,and the least decrease in lumbar vertebra region was 11.7%.4.The maximum decrease of T value in intertrochanter region was 127.4% between fracture group and control group,the minimum decrease was 32.7% in lumbar vertebra region,the decrease was 75.7% in femoral neck region,the decrease was93.5% in total hip region,the decrease was 68.4% in Ward area region.5.T value of lumbar vertebra is lower or close to the hip in control group,Decrease rate of T value in hip regions(including femoral neck,intertrochanter,Ward area,total hip region)was faster than the lumbar vertebra region in the fracture group,T value in hip regions wan lower or close to the lumbar vertebra,inverted T value of the ratio in the hip fracture.6.The T value ≤-2.5 of the proximal femur was accounted for 84% in the fracture group,the T value was 21% in control group,the T value ≤-3.5 was 31% in fracture group,the T value ≤-3.5 was not found in control group,16% cases in the fracture group did not reach the standard of osteoporosis(P <0.05),the degree of osteoporosis was significant different between the fracture group and control group(P <0.05),the T value ≤-2.5 of lumbar vertebra was accounted for 74% in fracture group,while T value was 45% in control group,the T value ≤-3.5 was accounted for 31% in fracture group,T value was 18% in control group,26% cases in fracture group did not reach the level of osteoporosis,the degree of osteoporosis was not significant different between the fracture group and control group(P> 0.05).Conclusions:1.The BMD of elderly patients with hip fracture was significantly lower than the patients without fracture,the result show that BMD was related with hip fracture,while the BMD was not related with the type of fracture.2.BMD of the hip was more valuable than BMD of lumbar vertebra for assessing the risk of hip fracture.3.When the BMD of hip in elderly is lower than about 25% of the BMD of hip in peer health people,while the T value of the ratio between the hip and lumbar vertebra was inverted,the risk of fracture was significantly increased.4.The risk of hip fracture was significant when the T value ≤-3.5 in the proximal femur.5.Some people with normal bone mass will be subjected to osteoporotic fractures still,While some patients with osteoporosis was not subjected to fractures,The results indicated that in addition to BMD,the skeletal microstructure had a certain impact on the occurrence of fracture. |
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