Comparison of Singh’s index in view of osteoporosis in patient with in tertrochanteric fracture and intracapsular fracture

Abstract

Background: Osteoporosis is a progressive, systemic, skeletal disease with low bone mass. Diagnosing osteoporosis in practice is a major challenge, where resources are limited and costly. Measurement of osteoporosis through Singh’s index in proximal femur fracture patients is consistent with Bone Mineral Density estimation like DEXA scan. Singh’s index is a reliable, reproducible and easily available investigation for osteoporosis. The aim of this study is to evaluate the Singh’s index of the patients with inter-trochanteric and intra-capsular fracture. Methods: A retrospective observational study of 20 IT and IC fracture each. Singh’s index evaluated from the X-rays at time of fracture presentation. Other required information collected at presentation. Results: Out of 40 Patients, 6 had Singh's Index Grade 1 (15%), 11 had Grade 2 (27.5%), 10 had Grade 3 (25%), 7 had Grade 4 (17.5%), 6 had Grade 5 (15%), 0 Patients had Singh’s index Grade 6. There was no noticeable significant variation in relation of gender with the type of fracture. Patients with higher age tend to have a lower grade of Singh’s index. Conclusions: Singh’s Index indeed represents bone quality and a fall in the grades predisposes to fractures. Inter trochanteric fractures are common in the older age group with poor Singh’s index (<3) compared to the relatively younger age group with Singh’s index around 3. Gender, exercise, history of hypertension and diabetes, sunlight exposure, etc. has no significant impact on Singh's Index. Age is deciding factor for Singh’s Index.