This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nielson, C. M. Search for Related Content PubMed PubMed Citation Articles by Nielson, C. M. Related Collections Calcium and Bone Metabolism Male Endocrinology

Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

Bone and Mineral Unit (C.M.N., E.S.O.), Department of Medicine, Oregon Health and Science University, Portland, Oregon 97239-3098; Orthopedic Biomechanics Laboratory (M.L.B.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215; Department of Medicine (S.S.F.), Federal University of Parana, Curitiba, Parana, Brazil 80060-000; and Department of Medicine (K.E.E.), Veterans Affairs Medical Center, Minneapolis, Minnesota 55417

Address all correspondence and requests for reprints to: Eric S. Orwoll, M.D., Bone and Mineral Unit, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode CR113, Portland, Oregon 97239-3098. E-mail: orwoll{at}ohsu.edu.

Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men.

Methods: We measured trochanteric soft tissue thickness by dual-energy x-ray absorptiometry for all incident hip fracture cases (n = 70) and 222 randomly selected noncases in older men (65 yr) enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Differences in tissue thickness between cases and controls were examined. Changes in fall force and factor-of-risk (the ratio of force from a sideways fall to femoral bone strength) associated with tissue thickness were determined. The relative risk for incident hip fracture per SD decrease in tissue thickness was calculated.

Results: Mean trochanteric soft tissue thickness did not differ significantly between cases and noncases (29.1 ± 11.9 vs 31.0 ± 11.5 mm; P = 0.2). Although increased tissue thickness reduced both the estimates of fall force and the factor-of-risk, tissue thickness was not associated with the risk of hip fracture (age- and bone mineral density-adjusted relative risk per SD decrease in tissue thickness = 0.90; 95% confidence interval, 0.70–1.16).

Conclusions: In this study of elderly community-dwelling men, we found no significant association between trochanteric soft tissue thickness and incident hip fracture. Trochanteric soft tissue thickness in these men was less than previously reported in older women and may explain the difference between these results and those reported in women.