Vitamin D deficiency in proximal femur fracture patients of South-East Queensland.

OBJECTIVES: To determine the incidence of hypovitaminosis D in proximal femur fracture (PFF) patients and investigate whether sociodemographic factors or radiographic parameters are associated with vitamin D levels. METHODS: This is a consecutive case series of South-East Queensland patients presenting with low-energy PFFs. Vitamin D levels and sociodemographic factors (age, sex, postcode, medications and type of residence) were collected from medical records. Radiographic parameters included PFF type and cortical thickness of the femur. RESULTS: A total of 313 patients were included (mean age = 79.5 years), and 105 (34%) were deficient in vitamin D (<50 nmol/L). There was no association between vitamin D levels and sociodemographic factors or radiographic parameters. Eighty-four (84%) of vitamin D-deficient patients were not taking vitamin D supplements. CONCLUSIONS: Social and demographic factors are not correlated with vitamin D levels in this cohort. Routine vitamin D supplementation may be indicated in ageing patients although it is not always protective of low-energy fractures.

Utility of an index metacarpal cortical thickness application as an osteoporosis screen in distal radius fracture patients aged over 50.

BACKGROUND: Following wrist fracture, it is desirable to identify patients with osteoporosis. A smartphone-based application (BoneGauge) that uses second metacarpal cortical thickness ratio (2MCP) measured on X-ray has been proposed. This study aims to validate this application using dual-energy X-ray absorptiometry scan in a cohort of patients with distal radius fractures. METHODS: Thirty subjects aged 50 and over who sustained low-energy fractures of the radius were recruited and measurements were completed by two independent observers using the application. RESULTS: The interrater reliability as a screening tool was insufficient (κ = 0.61). Using the 2MCP threshold of 60% for detection of osteopaenia or osteoporosis, we found insufficient correlation between the dual-energy X-ray absorptiometry scan and the two sets of readings using the application (κ = 0.28 and 0.35, respectively). CONCLUSION: On the basis of these results, 2MCP of 60% is not sensitive enough to be used as a screening tool via a smartphone application for assessment of osteoporosis risk.