Department of Orthopedic and Trauma Surgery, Babol University of Medical Sciences, Babol, Iran.
Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
PLoS One. 2024 Nov 22;19(11):e0313023. doi: 10.1371/journal.pone.0313023. eCollection 2024.
Hip fractures are highly prevalent in the elderly, with intertrochanteric (IT) fractures of the femur constituting about half of the fractures in this region. We aimed to evaluate the levels of serum calcium and vitamin D in patients with stable or unstable IT fractures to study their contribution to the severity of IT fracture.
Using a prospective cross-sectional design, we enrolled patients with IT fractures admitted to two referral orthopedic centers in 2022. Unstable IT fracture was defined as those with reverse obliquity or a trans-trochanteric pattern of fracture, a large or comminuted posteromedial fragment, and subtrochanteric extension of the fracture. Serum 25 (OH) vitamin D and calcium levels were the main study variables assessed by lab tests and compared among the two study groups: stable and unstable IT fractures.
A total of 286 patients with a mean age of 70.5 ± 7.3 years and a female predominance (60.4%) were included in the final analysis. Among the patients, 139 (48.6%) had stable IT fractures, and 147 (51.4%) had unstable IT fractures. The mean serum level of vitamin D was significantly higher in the stable group (30.3 ± 7.0) compared to the unstable group (26.5 ± 6.1) (P-value = 0.007). Increasing age was associated with a decreasing level of serum vitamin D; however, the association was weak and not statistically significant (P-value = 0.319). The mean serum calcium level was higher among stable cases (8.6 ± 0.7) compared to unstable cases (8.4 ± 0.9); however, the difference was not statistically significant (P-value = 0.540). Vitamin D and calcium levels were almost similar among males and females.
Lower levels of serum vitamin D were significantly associated with unstable IT fractures, and supplementation with this element might prevent severe fractures of this type and other fragility hip fractures.
髋部骨折在老年人中高发，股骨转子间骨折约占该区域骨折的一半。我们旨在评估稳定或不稳定转子间骨折患者的血清钙和维生素 D 水平，以研究其对转子间骨折严重程度的影响。
采用前瞻性横断面设计，我们招募了 2022 年在两家转诊骨科中心就诊的转子间骨折患者。不稳定转子间骨折定义为具有反向倾斜或经转子间骨折模式、大或粉碎的后内侧骨块以及骨折延伸至小转子下的骨折。通过实验室检查评估血清 25（OH）维生素 D 和钙水平作为主要研究变量，并在两组研究对象（稳定和不稳定转子间骨折）之间进行比较。
共有 286 名平均年龄为 70.5 ± 7.3 岁且女性居多（60.4%）的患者纳入最终分析。其中 139 名（48.6%）患者为稳定转子间骨折，147 名（51.4%）为不稳定转子间骨折。稳定组的平均血清维生素 D 水平（30.3 ± 7.0）明显高于不稳定组（26.5 ± 6.1）（P 值=0.007）。年龄增加与血清维生素 D 水平降低相关，但相关性较弱且无统计学意义（P 值=0.319）。稳定组的平均血清钙水平（8.6 ± 0.7）高于不稳定组（8.4 ± 0.9），但差异无统计学意义（P 值=0.540）。男性和女性的维生素 D 和钙水平几乎相似。
较低的血清维生素 D 水平与不稳定转子间骨折显著相关，补充这种元素可能有助于预防这种类型的严重骨折和其他髋部脆性骨折。
