Background

Intertrochanteric fractures are common fragility fractures in the elderly and are strongly associated with osteoporosis. Dual-energy X-ray absorptiometry (DEXA) is the gold standard for bone mineral density (BMD) assessment; however, variation in BMD across skeletal sites may affect osteoporosis detection. 

Objective

This study evaluated BMD at different skeletal sites in patients with intertrochanteric fractures and analysed the regional variation in bone mineral density which can enhance diagnostic precision, improve fracture risk assessment, and guide more effective measures for prevention and management in osteoporotic patients.

Methods

This observational study included patients with ≥ 50 years of age with radiologically confirmed intertrochanteric fractures meeting the inclusion criteria. Clinical and demographic data were recorded. BMD was measured using DEXA at the lumbar spine, femoral neck, and forearm at baseline and after the 6 months. T-scores were classified according to World Health Organization criteria. Statistical analysis was performed using Jamovi software.

Results

This study included 376 patients with intertrochanteric fractures meeting the inclusion criteria. Of these, 227 patients completed follow-up and were included in the final analysis. Study population predominantly comprised elderly patients with female preponderance. Osteoporosis was highly prevalent among patients with intertrochanteric fractures. Significant inter-site variation in BMD and T-scores was observed, with lower values commonly noted at the femoral neck. Multi-site DEXA assessment improved osteoporosis detection compared to single-site evaluation.

Conclusion

Osteoporosis is highly prevalent in patients with intertrochanteric fractures. Multi-site DEXA assessment improves diagnostic accuracy and may facilitate early intervention to reduce future fragility fractures.