Anthropometric measurements associated with intertrochanteric fractures in the elderly: a case-control study

Andy Ardiansyah; Sugeng Yuwana

doi:10.13181/mji.v28i4.2680

Authors

Andy Ardiansyah Department of Orthopaedics and Traumatology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
Sugeng Yuwana Department of Orthopaedics and Traumatology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia https://orcid.org/0000-0002-8759-2410

DOI:

https://doi.org/10.13181/mji.v28i4.2680

Keywords:

calf circumference, femoral fractures, intertrochanteric fractures, thigh circumference

Abstract

BACKGROUND Femoral intertrochanteric fracture is an important cause of disability in the elderly. Low muscle mass, especially those of the lower limbs, has been associated with osteoporosis and higher fall incidents. This study was aimed to assess the association between the anthropometric indices and intertrochanteric fractures.

METHODS This case-control study was performed from September 2013 to July 2015. The criteria of case group were elderly patients with intertrochanteric fractures admitted in Dr. Sardjito Hospital within 72 hours after a low energy injury without multiple fractures or pathological fracture. For control group, the subjects were matched according to age and gender without any fracture. Thigh and calf circumferences were done on healthy limbs. Body mass index (BMI) was calculated. History of steroid use was obtained. Adjusted odds ratio (OR) was calculated using logistic regression after analyzed with student's t-test or chi-square test.

RESULTS There were 82 subjects on each group. Smaller thigh and calf circumferences and also lower BMI were risk factors of intertrochanteric fractures. Thigh circumference <39 cm (aOR 5.12; 95% CI 2.30–11.43; p < 0.001) and calf circumference <29 cm (aOR 9.42; 95% CI 4.14–21.40; p < 0.001) were independently associated with intertrochanteric fracture after adjustment of BMI and steroid use.

CONCLUSIONS Calf and thigh circumferences were independently associated with femoral intertrochanteric fractures in Indonesian elderly.

Downloads

Download data is not yet available.

References

Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop. 2011;45(1):15-22. https://doi.org/10.4103/0019-5413.73656

Nasiri M, Luo Y. Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling. Bone. 2016;90:90-8. https://doi.org/10.1016/j.bone.2016.06.006

Díaz-Villegas G, Parodi JF, Merino-Taboada A, Perez-Agüero C, Castro-Viacava G, Runzer-Colmenares FM. Calf circumference and risk of falls among Peruvian older adults. Eur Geriatr Med. 2016;7(6):543-6. https://doi.org/10.1016/j.eurger.2016.01.005

Määttä M, Terho E, Jokinen H, Pulkkinen P, Korpelainen J, Heikkinen J. Lifestyle factors and site-specific risk of hip fracture in community dwelling older women - a 13- year prospective population-based cohort study. BMC Musculoskelet. 2012;13:173. https://doi.org/10.1186/1471-2474-13-173

Landi F, Onder G, Russo A, Liperoti R, Tosato M, Martone AM, et al. Calf circumference, frailty and physical performance among older adults living in the community. Clin Nutr. 2014;33(3):539-44. https://doi.org/10.1016/j.clnu.2013.07.013

Parker ED, Pereira MA, Virnig B, Folsom AR. The association of hip circumference with incident of hip fracture in a cohort of postmenopausal women: the Iowa Women's Health Study. Ann Epidemiol. 2008;18(11):836-41. https://doi.org/10.1016/j.annepidem.2008.07.007

Sjöblom S, Suuronen J, Rikkonen T, Honkanen R, Kröger H, Sirola J. Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas. 2013;75:175-80. https://doi.org/10.1016/j.maturitas.2013.03.016

Moayyeri A, Luben RN, Wareham NJ, Khaw K. Body fat mass is a predictor of risk of osteoporotic fractures in women but not in men: a prospective population study. J Intern Med. 2012;271(5):472-80. https://doi.org/10.1111/j.1365-2796.2011.02443.x

Blain H, Jaussent A, Thomas E, Micallef JP, Dupuy AM, Bernard PL, et al. Appendicular skeletal muscle mass is the strongest independent factor associated with femoral neck bone mineral density in adult and older men. Exp Gerontol. 2010;45(9):679- 84. https://doi.org/10.1016/j.exger.2010.04.006

Søgaard AJ, Holvik K, Omsland TK, Tell GS, Dahl C, Schei B, et al. Abdominal obesity increases the risk of hip fracture. A population-based study of 43,000 women and men aged 60- 79 years followed for 8 years. Cohort of Norway. J Intern Med. 2015;277(3):306-17. https://doi.org/10.1111/joim.12230

Sadeghi O, Saneei P, Nasiri M, Larijani B, Esmaillzadeh A. Abdominal obesity and risk of hip fracture: a systematic review and meta-analysis of prospective studies. Adv Nutr. 2017;8(5):728-38. https://doi.org/10.3945/an.117.015545

Matsushita Y, Nakagawa T, Shinohara M, Yamamoto S, Takahashi Y, Mizoue T, et al. How can waist circumference predict the body composition? Diabetol Metab Syndr. 2014;6:11. https://doi.org/10.1186/1758-5996-6-11

Vaez ID, Bufato HF, de Aguilar-Nascimento JE, Dock DD. SUN-P175: risk of sarcopenia by screening tool Sarc-F and presarcopenia by the calf circumference. Clin Nutr. 2017;36(Suppl 1):S118. https://doi.org/10.1016/S0261-5614(17)30453-3

Kanis JA, Johansson H, Oden A, Johnell O, de Laet C, Melton III LJ, et al. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res. 2004;19(6):893-9. https://doi.org/10.1359/JBMR.040134

Bruyère O, Beaudart C, Locquet M, Buckinx F, Petermans J, Reginster JY. Sarcopenia as a public health problem. Eur Geriatr Med. 2016;7(3):272-5. https://doi.org/10.1016/j.eurger.2015.12.002

Di Monaco M, Vallero F, Di Monaco R, Tappero R. Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Arch Gerontol Geriatr. 2011;52(1):71-4. https://doi.org/10.1016/j.archger.2010.02.002