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Contra-lateral hip fracture in the elderly: are decreased body mass index and skin thickness predictive factors?

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A correlation between soft tissue thickness and osteoporosis has been suggested. We aimed to estimate if a low body mass index (BMI) and/or a decrease of skin thickness could estimate the risk of contra-lateral hip fracture.


First, we performed a retrospective analysis of 1268 patients treated for a hip fracture. The 146 patients who had a contra-lateral hip fractures—study group—were compared with the 1078 patients who did not—control group. Four BMI categories were considered: obese, overweight, normal weight and low weight. Second, we enrolled prospectively 1000 consecutive patients in the emergency department. History of fractures, BMI, and skin aspect on the dorsum of both hands—classified as severe decrease thickness, moderate decrease thickness or normal—were recorded.


pt?>In the first part, we found that patients with contra-lateral fractures had a significantly lower BMI than those in the control group (22.2 Vs 26.5 kg/m2, p = 0.01). In the second part, 48 on 1000 patients had a hip fracture. Among them, six had a contra-lateral fracture. BMI was 23.4 kg/m2 in bilateral hip fractures, 33.68 kg/m2 in the unilateral fracture group, and 28.04 kg/m2 in the non-fracture group (p = 0.04). Finally, patients with contra-lateral hip fractures had a severe decrease thickness of the skin.


A low BMI and a decreased skin thickness increase independently the risk of fractures by three times. When associated, they increase the risk of fracture risk by five times. This combination had a sensitivity at 71 % and a specificity at 90 % for predicting hip fracture.

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The authors would like to thank Pr Philippe Hernigou for his constant help and support during the conduction of this study.

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Correspondence to Jean-Charles Aurégan.

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Aurégan, JC., Frison, A., Bégué, T. et al. Contra-lateral hip fracture in the elderly: are decreased body mass index and skin thickness predictive factors?. International Orthopaedics (SICOT) 41, 247–252 (2017).

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