Black et al developed the FRACTURE index to determine the risk of fracture in a postmenopausal woman. This can help identify a woman who may benefit from an intervention. The authors are from the University of California at San Francisco, Procter and Gamble Pharmaceuticals, INSERM Unit in Villejuif (France), Helen Hayes Hospital (New York), and Malmo General Hospital (Sweden).
Patient selection: postmenopausal woman
Parameters:
(1) age in years
(2) any bone fracture after age 50
(3) maternal history of hip fracture after age 50
(4) body weight
(5) current smoking
(6) standing up from a chair
(7) T-score from bone mineral density at hip
|
Parameter |
Finding |
Points |
|
age in years |
< 65 years |
0 |
|
|
65 to 69 years of age |
1 |
|
|
70 to 74 years of age |
2 |
|
|
75 to 79 years of age |
3 |
|
|
80 to 84 years of age |
4 |
|
|
>= 85 years of age |
5 |
|
bone fracture after age 50 |
no |
0 |
|
|
yes |
1 |
|
maternal history of hip fracture |
no |
0 |
|
|
yes |
1 |
|
body weight |
> 125 pounds (56.8 kg) |
0 |
|
|
<= 125 pounds |
1 |
|
current smoking |
no |
0 |
|
|
yes |
1 |
|
standing up from chair |
no need to use the arms in order to get up |
0 |
|
|
need to use arms in order to get up from a chair |
2 |
|
T score at hip |
>= -1.0 |
0 |
|
|
-2 to -1.01 |
2 |
|
|
-2.5 to -2.01 |
3 |
|
|
< -2.5 |
4 |
where:
• A bone fracture after age 50 could be due to significant trauma.
total index score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the greater the risk for hip fracture.
|
Index |
Percent with Hip Fracture |
|
1 or 2 |
0.4% |
|
3 or 4 |
0.9% |
|
5 |
1.9% |
|
6 or 7 |
3.9% |
|
8 to 13 |
8.7% |
Purpose: To evaluate a postmenopausal woman for risk of osteoporotic hip fracture using the FRACTURE index of Black et al.
Specialty: Surgery, orthopedic, Endocrinology, Nutrition
Objective: risk factors
ICD-10: M80-M85,
