Title: Singhs Index Assessment in Patients Having Sustained Hip Fractures

Authors: Dr Ramanujam P, Dr Sabarisree.M

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.42

Abstract

Background: Fractures around the hip joint is very common in elderly patients. Risk of osteoporosis is high in the population above 65 years especially in females. The trabecular pattern of arrangement of cancellous bone becomes thinner making them vulnerable to fractures with trivial trauma.

This study aims to identity the risk of fractures in patients above 60 years based on Radiologic assessment of trabecular pattern of femoral neck.

A score designed sign is used as a guide.

Materials and Methods: This is a retrospective study of 70 (seventy) patients above the age of sixty admitted with various patterns of hip fractures. This includes intracapsular fracture and intertrochanteric fractures.

A plain AP view x-ray on standardized   cassette was taken.

Radiologic assessment of trabecular pattern of femoral neck was done based on Singh’s index score.

Score   6          -           indicates all trabeculae present

            5          -           Attenuation of secondary tension trabeculae  (ST)

            4          -           Attenuation of secondary compression trabeculae  (SC)

            3          -           Attenuation of SC, ST trabecula with primary tension attenuation (PT)

            2          -           Attenuation of primary (PC) compression trabeculae along with attenuation of

                                    PT, SC, ST trabeculae.

            1          -           All trabeculae are very much thinned out.

The trabeculae analyzed are primary compression (PC) – Main secondary compensation (SC)

Primary tension (PT)  - Secondary tension (ST)

Results: All patients with Hip fractures had Singh’s index of 3 and below.

Conclusion: Risk of osteoporosis increases with age. Patients above sixty (60) years are vulnerable. They have osteoporosis and Singhsindex of 6, 5, 4 were relatively immune but patients with Singhs index of 3 and below were definitely susceptible.

References

  1. M. Maini.P.S.-Changes in trabecular pattern of upper end of femur as an idea of osteoporosis JBJS-1970.
  2. Krishak, Augat. P, Kin21, predictive value of bone mineral density and Singhs index for mechanical properties of cancellous bone in Femoral Head. Journal of Clinical Biomechanics -1999.
  3. S. Modified Singhs index in diagnosing femoral neck osteoporosis 2011, (Pubmed).
  4. S.H. Murphy. K. P. Fracture of proximal femur correlates of radiological evidence of Osteoporosis 2006-(Pubmed).
  5. Hauschild, Obsert. M. Evaluation of Singhs index for assessment of osteoporosis using digital radiography 2009 (Pubmed).
  6. M-insights into bone fragility in Diabetes, crucial role of bone qualityon skeletal strength 2015 (Pubmed).

Corresponding Author

Dr Sabarisree.M

Additional Professor in Orthopaedics, Government Medical College, Thiruvananthapuram, India