In-Depth Oral Presentations and Oral Communications
Journal of Orthopaedics and Traumatology
Introduction The femoral cortical index (FCI) assesses bone stock using the ratio between the diameter of the femoral shaft and the thickness of the cortical bone calculated 10 cm distal to the centre of the small trochanter in an AP view X-ray of the femur. Aim of our study is to evaluate a possible association among low values of FCI, risk factors, comorbidities and serum 25 hydroxy-vitamin D levels and to establish the importance of FCI as a potential predictor of a new fracture. Materials
... d methods We conducted a retrospective study on 160 consecutive patients (44 men and 116 women) (range 60 to 103 years) surgically treated for hip fractures in 2012. FCI has been calculated by routine clinical radiographs of the pelvis both on fractured femur and on the opposite side. For each patient, we analyzed the presence of co-morbidities, risk factors and blood levels of vitamin D. Results Average values of FCI were 0.42 (range 0.18-0.58) at the fractured femur and 0.48 at the opposite side (range 0.25-0.66, p = 0.002). At the fractured side an average value of 0.45 was found in men, and of 0.40 in women. Patients with severe hypovitaminosis D (serum concentration \12 ng/ml) had a minor FCI compared to those with a moderate deficiency (0.41 vs 0.46, p \ 0.01). The presence of co-morbidities or osteoporosis risk factors had a different influence on the values of FCI. Lower values of CIF were found on the first fractured femur in patients with bilateral femur fracture. Discussion We found a correlation among low values of FCI, clinical factors related to bone fragility and severe hypovitaminosis D in elderly patients with hip fractures. The lowest levels of CIF found in patients with bilateral fracture of the femur may suggest that this parameter can be considered as a predictor of a new fracture. It is still discussed the association with the values provided by the DXA, because of the low specificity of densitometry. Conclusions FCI could be useful to evaluate bone fragility and predict fracture risk. As osteoporosis causes a cortical bone trabecularization that leads to fracture, this index can therefore give a measure of specific cortical bone at low cost using a X-ray standard examination.