Frequency of Osteomalacia in Elderly Patients With Hip Fracture

Osteomalacia represents a risk factor for hip fracture (HF), which is one of the most common and costly injuries in elderly.
This study was performed to determine the frequency of histopathologic and laboratory osteomalacia in elderly patients with HF.
Patients and Totally, 87 patients with HF, admitted to Imam Khomeini hospital, Tehran, Iran, from 2005 to 2006, were studied. Laboratory investigations included serum calcium, phosphorus, alkaline phosphatase (ALP), albumin and 25-hydroxy vitamin D3 [25 (OH) D3]. Open biopsy from ipsilateral iliac crest was performed during the same surgery.
The average age was 78.06 ± 8.4 years. Bone biopsy showed osteomalacia in eight patients (9.2%), hypocalcaemia in 42.5%, hypophosphatemia in 17.2%, hypoalbuminemia in 66.6% and 25 (OH) D3 deficiencies in 66.6%. Concomitant hypophosphatemia and hypovitaminosis [25 (OH) D3 Elderly patients with femoral neck or intertrochanteric fractures may have osteomalacia, as a treatable cause for osteopenia, and laboratory tests may not be precise criteria for diagnosis in HF patients.