Bone Abstracts

Purpose: Risk factors for intertrochanteric fracture (IF) severity were not studied thoroughly despite the high failure rate of osteosynthesis. The purpose of this study was to identify the risk factor for each fracture type using AO/OTA classification in elderly female patients who experienced IF.

Materials and methods: This retrospective study identified 240 women over 50 years old with an incident IF in whom dual-energy x-ray absorptiometry (DEXA) was obtained. Two independent orthopaedic specialists graded the fracture severity by AO/OTA classification. Age, body weight, height, BMI and trochanteric T-score were used in univariate and multivariate logistic regression analysis to identify risk factors for each fracture type as well as unstable IF.

Results: 44.4% (106 hips) were graded as unstable IF. Lower BMD (OR 0.743, P=0.049), body weight (OR 0.970, P=0.031) and BMI (OR 0.927, P=0.045) predicted AO/OTA 31 A1 fracture while higher BMD (OR 1.443, P=0.010), body weight (OR 1.036, P=0.010), and BMI (OR 1.089, P=0.023) predicted A2 fracture after univariate logistic regression. Increased body weight (OR 1.027, P=0.044) was the only independent risk factor for unstable IF after multiple logistic regression.

Conclusion: The higher the body weight, the greater the likelihood of experiencing an IF that is more unstable and displaced in elderly women. Therefore, these patients should be warned about the possibility of severe form of IF and treated to lose weight.