Bone mineral density in fracture neck of femur patients: What's the significance?

BACKGROUND: The National Institute for Health and Care Excellence (NICE) guidelines have advised further research is required into investigating the added prognostic value of bone mineral density (BMD) in the assessment of fracture risk with the Fracture Risk Assessment Tool (FRAX) score. AIM: To investigate the significance of BMD in fracture neck of femur patients and compare it to the outcome of the FRAX score. METHODS: Inclusion criteria for this study were all patients who underwent dual-energy X-ray absorptiometry (DXA) scan following fracture neck of femur between 2015 and 2017. Analysis of BMD, FRAX scores and patient demographic data was undertaken. RESULTS: A total of 69 patients were included in the study, mean age 74.1 years. There was no significant difference between mean BMD of the femoral neck in males (0.65) as compared to females (0.61) (P = 0.364). Analyses showed no significant correlation between BMD and menopause age (r(s )= -0.28, P = 0.090). A significant difference was seen of the femoral neck BMD between the different fracture pattern types (P = 0.026). A stronger correlation was observed between BMD of femoral neck and FRAX major score (r(s )= -0.64, P < 0.001) than with BMD of lumbar spine and FRAX major score (r(s )= -0.37, P = 0.003). CONCLUSION: This study demonstrated that BMD of the femoral neck measured by DXA scan is of added prognostic value when assessing patients for risk of fracture neck of femur in combination with the FRAX predictive scoring system.