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

Mohammed Jaan  Basha; Hunaina Mansufa; Mohammed Jalal Mohiuddin; Sajid Salman; C. Shamsunder

doi:10.18203/issn.2455-4510.IntJResOrthop20241116

Authors

Mohammed Jaan Basha Department of Orthopaedics, Deccan College of Medical Sciences, Santosh Nagar, Hyderabad, Telangana, India
Hunaina Mansufa Department of Orthopaedics, Deccan College of Medical Sciences, Santosh Nagar, Hyderabad, Telangana, India
Mohammed Jalal Mohiuddin Department of Orthopaedics, Deccan College of Medical Sciences, Santosh Nagar, Hyderabad, Telangana, India
Sajid Salman Department of Orthopaedics, Deccan College of Medical Sciences, Santosh Nagar, Hyderabad, Telangana, India
C. Shamsunder Department of Orthopaedics, Deccan College of Medical Sciences, Santosh Nagar, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20241116

Keywords:

Osteoporosis, Intra-Capsular, Intertrochanteric, Trabeculae, Singh's index

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.

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References

Kadam NS. Prevalence of osteoporosis in apparently healthy adults above 40 years of age in Pune City, India. Indian J Endocrinol Metab. 2018;22(1):67-73.

Thulkar J, Singh S. Overview of research studies on osteoporosis in menopausal women since the last decade. J Midlife Health. 2015;6:104-7.

Hunter DJ, Sambrook PN. Bone loss. Epidemiology of bone loss. Arthritis Res Ther. 2000;2:441-5.

Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, et al. Long- term risk of osteoporotic fracture in Malmö. Osteoporos Int. 2000;11:669-74.

Mithal A, Bansal B, Kyer CS, Ebeling P. The Asia pacific regional audit epidemiology, costs, and burden of osteoporosis in India 2013: A report of international osteoporosis foundation. Indian J Endocrinol Metab. 2014;18:449-54.

Singh Index. Available at: https://radiopaedia.org/ singh-index. Accessed on 20 November 2023.

Kanakaris NK, Lasanianos NG. Singh Index for Osteoporosis, Trauma and Orthopaedic Classifications. London: Springer; 2015;1:405-7.

Natu N, Yadav S, Kosta S, Dave A, Kumar R. Detection of Osteoporosis in Postmenopausal women by Singh’s Index. J South Asian Fed Menopause Soc. 2016;4:8-

Klatte TO, Vettorazzi E, Beckmann J. The Singh Index does not correlate with bone mineral density (BMD) measured with dual energy X-ray absorptiometry (DXA) or peripheral quantitative computed tomography (pQCT). Arch Orthop Trauma Surg. 2015;135:645.

Deeptiman J, Sarah W. Determining prevalence of osteoporosis in health seeking population of rural central India using Singh’s Index: a resource optimization model to fight a silent epidemic. Chrismed J Health Res. 2018;5:173-7.

Ramanujam P. Singhs index assessment in patients having sustained hip fractures. JMSCR. 2020; 8(6):232-4.

Sandeep A. Simple analysis of osteoporosis with Singh’s Index Can it help in predicting the type of fracture?. Indian J Orthopaed Surg. 2019;5(3):176-81.

Bishnoi M, Kirmani TT, Huda N, Chahol G, Bishnoi S. Epidemological analysis of hip Fracture at a tertiary carecentre: A Retrospective Study. Int J Res Orthop. 2018;4;568-71.

Soheyli AA, Golestan B, Jahanbakhsh S. Determination of the relation between osteoporotic and osteopenic risk factors among women referring to BMD center, baharloo hospital. Razi J Med Sci. 2008;14(57):91-9.

Heydari Z. An Investigation of the Risk Factors of Osteoporosis and the Correlation between Opium Consumption and Osteoporosis in Adults. Addict Health. 2017;9(4):214-21.