Related Experiment Video
Updated: Jul 20, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Young patients with hip fracture: a population-based study of bone mass and risk factors for osteoporosis
C M Lofthus1, E K Osnes, H E Meyer
1Centre of Endocrinology, Aker University Hospital and University of Oslo, Oslo, Norway. c.m.lofthus@medisin.uio.no
Insights
Young patients with hip fractures often experience low-energy trauma and have numerous osteoporosis risk factors. Their bone mineral density (BMD) is significantly lower than in the general population, regardless of injury type.
Area of Science:
- Orthopedics
- Endocrinology
- Gerontology
Background:
- Hip fractures are rare in young individuals (20-49 years).
- Understanding comorbidity patterns and risk factors is crucial for this demographic.
Purpose of the Study:
- To investigate the comorbidity patterns and risk factors associated with hip fractures in young patients.
- To compare bone mineral density (BMD) in young hip fracture patients with a healthy reference population.
Main Methods:
- Identified hip fracture patients aged 20-49 from Oslo hospital records (n=49).
- Collected detailed medical histories, conducted interviews, and administered questionnaires to assess osteoporosis risk factors.
- Measured bone mineral density (BMD) using dual x-ray absorptiometry (DXA) and compared Z-scores to healthy Oslo subjects.
Main Results:
- Most fractures resulted from low-energy trauma (falls at same level).
- Patients exhibited higher prevalence of alcohol/drug abuse, neuromuscular diseases, and endocrine diseases.
- Significantly lower BMD (Z-scores) observed in lumbar spine, femoral neck, and total body compared to controls (p<0.001).
- Negative correlation found between number of risk factors and BMD.
Conclusions:
- Young hip fracture patients frequently have comorbidities predisposing to falls or reduced bone strength.
- Osteoporosis risk factors are prevalent, contributing to lower bone mineral density regardless of trauma mechanism.
- Early identification and management of osteoporosis risk factors are essential in young individuals with hip fractures.
Introduction:
Hip fracture in young patients is rare. The present study was aimed to clarify the comorbidity pattern and reveal relevant risk factors for osteoporosis and fracture in this patient group.
Materials And Methods:
Using electronic diagnosis registers and lists of the operating theatres for the Oslo hospitals, patients with new hip fracture during two 1-year periods from May 1994 through April 1995 and from May 1996 through April 1997 were identified. All patients age 20-49 years at the time of fracture were included (n=49), and a detailed medical history was recorded. Thirty-two of the patients volunteered for examination and completed a questionnaire and interview to reveal risk factors for osteoporosis. Data from the Oslo Health Study served as reference material. Bone mineral density (BMD) was measured using dual x-ray absorptiometry, and Z-scores were calculated using healthy subjects from Oslo as reference.
Results:
Of the patients identified, the median age was 40 years (range 25-49), and 63% were men. In 65% of the patients, the fracture occurred after a fall at the same level, in 16% it occurred after a fall from a higher level, and in 18% it occurred in a traffic accident. Twenty percent of the patients had a history of alcohol or drug abuse, 39% had neuromuscular diseases, and 12% had endocrine diseases. The patients examined had significantly more risk factors for osteoporosis than the reference population. The BMD expressed as Z-score for L2-4 was -1.0+/-0.9 (mean +/- SD; p<0.001), for femoral neck was -1.5+/-1.0 (p<0.001), and for total body was -1.3+/-1.1 (p<0.001). BMD was significantly lower than in controls for patients sustaining low-energy and high-energy trauma. There was a negative correlation between the total number of risk factors and BMD for lumbar spine (r=-0.35, p<0.05), femoral neck (r=-0.37, p=0.04), and total body (r=-0.55, p=0.001), respectively.
Conclusions:
The majority of the young patients with hip fracture have a history of low-energy trauma, comorbidity predisposing for falls or decreased bone strength, as well as several risk factors for osteoporosis. The BMD was significantly lower than in the reference population regardless of the trauma mechanism.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:31Osteoclasts in Bone Remodeling
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:25Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...