Frequency of Osteomalacia in Elderly Patients With Hip Fracture

Background: osteomalacia represents a risk factor for hip fracture (hf), which is one of the most common and costly injuries in elderly.objectives: this study was performed to determine the frequency of histopathologic and laboratory osteomalacia in elderly patients with hf.patients and methods: 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.results: 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 < 10 ng/ml] was detected in 13 patients (14.6%). an increased level of serum alp was found in 52.8%. five (38.5%) patients had only laboratory osteomalacia, when histopathological findings were negative.conclusions: 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.