Aurégan Jean-Charles, Frison Aurélien, Bégué Thierry, Hannouche Didier, Bosser Catherine, Bensidhoum Morad, Hoc Thierry
Department of Orthopedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140, Clamart, France.
Laboratory of Tribology and System Dynamics (LTDS - UMR CNRS 5513), Ecole Centrale Lyon, 36 avenue Guy de Collongues, 69134, Ecully, France.
Int Orthop. 2017 Feb;41(2):247-252. doi: 10.1007/s00264-016-3264-6. Epub 2016 Aug 9.
A correlation between soft tissue thickness and osteoporosis has been suggested. We aimed to estimate if a low body mass index (BMI) and/or a decrease of skin thickness could estimate the risk of contra-lateral hip fracture.
First, we performed a retrospective analysis of 1268 patients treated for a hip fracture. The 146 patients who had a contra-lateral hip fractures-study group-were compared with the 1078 patients who did not-control group. Four BMI categories were considered: obese, overweight, normal weight and low weight. Second, we enrolled prospectively 1000 consecutive patients in the emergency department. History of fractures, BMI, and skin aspect on the dorsum of both hands-classified as severe decrease thickness, moderate decrease thickness or normal-were recorded.
pt?>In the first part, we found that patients with contra-lateral fractures had a significantly lower BMI than those in the control group (22.2 Vs 26.5 kg/m, p = 0.01). In the second part, 48 on 1000 patients had a hip fracture. Among them, six had a contra-lateral fracture. BMI was 23.4 kg/m in bilateral hip fractures, 33.68 kg/m in the unilateral fracture group, and 28.04 kg/m in the non-fracture group (p = 0.04). Finally, patients with contra-lateral hip fractures had a severe decrease thickness of the skin.
A low BMI and a decreased skin thickness increase independently the risk of fractures by three times. When associated, they increase the risk of fracture risk by five times. This combination had a sensitivity at 71 % and a specificity at 90 % for predicting hip fracture.
软组织厚度与骨质疏松症之间存在关联。我们旨在评估低体重指数（BMI）和/或皮肤厚度降低是否可用于评估对侧髋部骨折的风险。
首先，我们对1268例接受髋部骨折治疗的患者进行了回顾性分析。将146例发生对侧髋部骨折的患者（研究组）与1078例未发生对侧髋部骨折的患者（对照组）进行比较。考虑了四个BMI类别：肥胖、超重、正常体重和低体重。其次，我们前瞻性地纳入了急诊科的1000例连续患者。记录骨折史、BMI以及双手背部的皮肤状况（分为厚度严重降低、厚度中度降低或正常）。
在第一部分中，我们发现对侧骨折患者的BMI显著低于对照组（22.2比26.5kg/m²，p = 0.01）。在第二部分中，1000例患者中有48例发生髋部骨折。其中，6例发生对侧骨折。双侧髋部骨折患者的BMI为23.4kg/m²，单侧骨折组为33.68kg/m²，非骨折组为28.04kg/m²（p = 0.04）。最后，对侧髋部骨折患者的皮肤厚度严重降低。
低BMI和皮肤厚度降低分别使骨折风险增加三倍。两者同时存在时，骨折风险增加五倍。这种组合对预测髋部骨折的敏感性为71%，特异性为90%。
