{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T20:01:27Z","timestamp":1765396887592,"version":"3.46.0"},"reference-count":30,"publisher":"BMJ","issue":"6417","license":[{"start":{"date-parts":[[1984,2,25]],"date-time":"1984-02-25T00:00:00Z","timestamp":446515200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,2,25]]},"abstract":"<jats:p>A prospective study of fractures of the femoral neck was conducted over 12 months in order to ascertain the relevance of generalised osteoporosis as determined by metacarpal morphometry. A series of some 200 women sustaining a fracture of the femoral neck after minor trauma had bone mass measurements similar to those of a control population of normal women, and 16% were not osteoporotic. A history of previous fractures was documented in one third of the women, but this was unrelated to the presence or severity of osteoporosis, although over half of the fractures had occurred within the previous four years. Trochanteric fractures were seen more commonly in severely osteoporotic women (p less than 0.005), whereas cervical fractures predominated in those who were not osteoporotic. These findings support the hypothesis that postural instability is the major determinant for femoral neck fracture and that generalised osteoporosis, rather than being a prerequisite for fracture, merely determines the type of fracture sustained.<\/jats:p>","DOI":"10.1136\/bmj.288.6417.597","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"597-601","source":"Crossref","is-referenced-by-count":76,"title":["Relevance of osteoporosis in women with fracture of the femoral neck."],"prefix":"10.1136","volume":"288","author":[{"given":"J M","family":"Aitken","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1984,2,25]]},"reference":[{"issue":"17","key":"ref_1","first-page":"219","article-title":"Epidemiology of fracture in aged persons","volume":"1960","author":"Bauer, G.C.H.","unstructured":"Bauer GCH. Epidemiology of fracture in aged persons. Clin Orthop 1960;17:219-25.","journal-title":"Clin Orthop"},{"key":"ref_2","first-page":"163","article-title":"Epidemiology of fractures of the proximal femur in Rochester, Minnesota","volume":"150","author":"Gallagher, J.C.; Melton, L.J.; Riggs, B.L.; Bergstrath, E.","year":"1980","unstructured":"Gallagher JC, Melton LJ, Riggs BL, Bergstrath E. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop 1980;150:163-71.","journal-title":"Clin Orthop"},{"issue":"44","key":"ref_3","first-page":"520","article-title":"The incidence of osteoporosis in patients with femoral neck fracture","volume":"1962","author":"Stevens, J.; Freeman, P.A.; Nordin, B.E.C.; Barnett, E.","unstructured":"Stevens J, Freeman PA, Nordin BEC, Barnett E. The incidence of osteoporosis in patients with femoral neck fracture. J Bone J'oint Surg 1962;44B:520-7.","journal-title":"J Bone J'oint Surg"},{"key":"ref_4","first-page":"229","article-title":"Frequency of osteomalacia and osteoporosis in fractures of the proximal femur","volume":"i:","author":"Aaron, J.E.; Gallagher, J.C.; Anderson, J.","year":"1974","unstructured":"Aaron JE, Gallagher JC, Anderson J, et al. Frequency of osteomalacia and osteoporosis in fractures of the proximal femur. Lancet 1974;i: 229-33.","journal-title":"Lancet"},{"key":"ref_5","first-page":"1038","article-title":"Long-term prevention of postmenopausal osteoporosis by oestrogen","volume":"i:","author":"Lindsay, R.; Hart, D.M.; Aitken, J.M.; MacDonald, E.B.; Anderson, J.B.; Clarke, A.C.","year":"1976","unstructured":"Lindsay R, Hart DM, Aitken JM, MacDonald EB, Anderson JB, Clarke AC. Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet 1976;i:1038-41.","journal-title":"Lancet"},{"key":"ref_6","first-page":"789","article-title":"Prospective trial of oestrogen and calcium in postmenopausal women","volume":"ii:","author":"Horsman, A.; Gallagher, J.C.; Simpson, M.; Nordin, B.E.C.","year":"1977","unstructured":"Horsman A, Gallagher JC, Simpson M, Nordin BEC. Prospective trial of oestrogen and calcium in postmenopausal women. Br Med J 1977; ii:789-92.","journal-title":"Br Med J"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1056\/NEJM198202253060802","article-title":"Effect of the fluoride\/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis","volume":"306","author":"Riggs, B.L.; Seeman, E.; Hodgson, S.F.; Taves, D.R.; O'Fallon, W.M.","year":"1982","unstructured":"Riggs BL, Seeman E, Hodgson SF, Taves DR, O'Fallon WM. Effect of the fluoride\/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. N Engi J Med 1982;306:446-50.","journal-title":"N Engi J Med"},{"issue":"4","key":"ref_8","first-page":"1","article-title":"The measurement of sequential changes in cortical bone geometry","volume":"48","author":"Horsman, A.; Simpson, M.","year":"1975","unstructured":"Horsman A, Simpson M. The measurement of sequential changes in cortical bone geometry. Br J Radiol 1975;48:4, 1-6.","journal-title":"Br J Radiol"},{"key":"ref_9","first-page":"5","article-title":"Non-invasive measurement of bone","author":"Mazess, R.B.","year":"1979","unstructured":"Mazess RB. Non-invasive measurement of bone. In: Barzel U, ed. Osteoporosis II. New York: Grune and Stratton, 1979:5-26."},{"key":"ref_10","first-page":"172","article-title":"The national cost of acute care of hip fractures associated with osteoporosis","volume":"150","author":"Owen, R.A.; Melton, L.J.; Gallagher, J.C.; Riggs, B.L.","year":"1980","unstructured":"Owen RA, Melton LJ, Gallagher JC, Riggs BL. The national cost of acute care of hip fractures associated with osteoporosis. Clin Orthop 1980;150:172-6.","journal-title":"Clin Orthop"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0140-6736(83)92358-9","article-title":"The increasing incidence of fractures of the proximal femur: an orthopaedic epidemic","volume":"i:","author":"Wallace, W.A.","year":"1983","unstructured":"Wallace WA. The increasing incidence of fractures of the proximal femur: an orthopaedic epidemic. Lancet 1983;i:1413-4.","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/B978-0-407-02273-7.50007-5","article-title":"The prevention of osteoporosis","volume-title":"Clinical endocrinology 2: calcium disorders","author":"Aitken, J.M.","year":"1982","unstructured":"Aitken JM. The prevention of osteoporosis. In: Heath DA, Marx SJ, eds. Clinical endocrinology 2: calcium disorders. London: Butterworth Scientific, 1982:47-68."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0009-9260(72)80133-8","article-title":"The accuracy and reproducibility of bone mineral measurements \"in vivo\"; a) the measurement of metacarpal mineralisation using an x-ray generator","volume":"23","author":"Shimmins, J.; Anderson, J.B.; Smith, D.A.; Aitken, J.M.","year":"1972","unstructured":"Shimmins J, Anderson JB, Smith DA, Aitken JM. The accuracy and reproducibility of bone mineral measurements \"in vivo\"; a) the measurement of metacarpal mineralisation using an x-ray generator. Clin Radiol 1972;23:42-6.","journal-title":"Clin Radiol"},{"issue":"11","key":"ref_14","first-page":"166","article-title":"The radiological diagnosis of osteoporosis: a new approach","volume":"1960","author":"Barnett, E.; Nordin, B.E.C.","unstructured":"Barnett E, Nordin BEC. The radiological diagnosis of osteoporosis: a new approach. Clin Radiol 1960;11:166-74.","journal-title":"Clin Radiol"},{"key":"ref_15","first-page":"25","article-title":"The incidence of osteoporosis in normal women: its relation to age and the menopause","volume":"137","author":"la Nordin BEC; J, MacGregor; DA, Smith","year":"1966","unstructured":"la Nordin BEC, MacGregor J, Smith DA. The incidence of osteoporosis in normal women: its relation to age and the menopause. Q J Med 1966; 137:25-38.","journal-title":"Q J Med"},{"key":"ref_16","article-title":"Osteoporosis","author":"Smith, D.A.S.","year":"1971","unstructured":"Smith DAS. Osteoporosis. Glasgow: Glasgow University, 1971. MD thesis."},{"key":"ref_17","first-page":"23","article-title":"Changes in metacarpal mineral content and density in normal male and female subjects with age. Clin Radiol 1969; 20","author":"Smith, D.A.; Anderson, J.B.; Shimmins, J.; Speirs, C.F.; Barnett, E.","unstructured":"Smith DA, Anderson JB, Shimmins J, Speirs CF, Barnett E. Changes in metacarpal mineral content and density in normal male and female subjects with age. Clin Radiol 1969;20:23-31."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/ort.1964.35.suppl-65.01","article-title":"An epidemiologic study of cervical and trochanteric fractures of the femur in an urban population","volume":"65","author":"Alffram, P.-A.","year":"1964","unstructured":"Alffram P-A. An epidemiologic study of cervical and trochanteric fractures of the femur in an urban population. Acta Orthop Scand 1964;suppl 65: 1-109.","journal-title":"Acta Orthop Scand"},{"key":"ref_19","first-page":"144","article-title":"Fifty-year trend in hip fracture incidence","volume":"162","author":"Melton, L.J.; Ilstrup, D.M.; Riggs, B.L.; Beckenbaugh, R.D.","year":"1982","unstructured":"Melton LJ, Ilstrup DM, Riggs BL, Beckenbaugh RD. Fifty-year trend in hip fracture incidence. Clin Orthop 1982;162:144-9.","journal-title":"Clin Orthop"},{"key":"ref_20","first-page":"175","article-title":"Cortical and trabecular osteoporosis and their relation to fractures in the elderly","author":"n Horsman A; BEC, Nordin; J, Aaron; DH, Marshall","year":"1981","unstructured":"n Horsman A, Nordin BEC, Aaron J, Marshall DH. Cortical and trabecular osteoporosis and their relation to fractures in the elderly. In: Deluca HF, Frost HM, Jee WSS, Johnston CC, Parfitt AM, eds. Osteoporosis. Baltimore: University Park Press, 1981:175-84."},{"key":"ref_21","first-page":"370","article-title":"The interrelationships between bone mineral at different skeletal sites in male and female cadavera","volume":"56","author":"Aitken, J.M.; Smith, C.B.; Horton, P.W.; Clark, D.L.; Boyd, J.F.; Smith, D.A.","year":"1974","unstructured":"Aitken JM, Smith CB, Horton PW, Clark DL, Boyd JF, Smith DA. The interrelationships between bone mineral at different skeletal sites in male and female cadavera. J Bone Joint Surg 1974;56B:370-5.","journal-title":"J Bone Joint Surg"},{"key":"ref_22","first-page":"17","article-title":"International patterns of osteoporosis","volume":"45","author":"Nordin, B.E.C.","year":"1966","unstructured":"Nordin BEC. International patterns of osteoporosis. Clin Orthop 1966; 45: 17-30.","journal-title":"Clin Orthop"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/0020-1383(82)90132-2","article-title":"Bilateral fractures of the femoral neck","volume":"14","author":"Boston, D.A.","year":"1982","unstructured":"Boston DA. Bilateral fractures of the femoral neck. Injury 1982;14: 207-10.","journal-title":"Injury"},{"key":"ref_24","first-page":"1685","article-title":"On the natural history of falls in old age. Br MedJ7 1960","author":"Sheldon, J.H.","unstructured":"Sheldon JH. On the natural history of falls in old age. Br MedJ7 1960;ii: 1685-90."},{"key":"ref_25","first-page":"27","article-title":"For people in their 60s, fractures and falls are a special hazard","author":"Exton-Smith, A.N.","year":"1976","unstructured":"Exton-Smith AN. For people in their 60s, fractures and falls are a special hazard. Modern Geriatrics 1976;July:27-30.","journal-title":"Modern Geriatrics"},{"issue":"84","key":"ref_26","first-page":"33","article-title":"Osteoporosis in women 45 years and over related to subsequent fractures","volume":"1969","author":"Iskrant, A.P.; Smith, R.W.","unstructured":"Iskrant AP, Smith RW. Osteoporosis in women 45 years and over related to subsequent fractures. Public Health Rep 1969;84:33-8.","journal-title":"Public Health Rep"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1302\/0301-620X.50B1.2","article-title":"Osteoporosis and fracture of the femoral neck in the South African Bantu","volume":"50","author":"Solomon, L.","year":"1968","unstructured":"Solomon L. Osteoporosis and fracture of the femoral neck in the South African Bantu. Jf Bone Joint Surg 1968;50B:2-13.","journal-title":"Jf Bone Joint Surg"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/S0140-6736(79)92813-7","article-title":"Bone density in ageing Caucasian and African populations","volume":"ii:","author":"Solomon, L.","year":"1979","unstructured":"Solomon L. Bone density in ageing Caucasian and African populations. Lancet 1979;ii:1326-30.","journal-title":"Lancet"},{"article-title":"Accepted 17","year":"1983","key":"ref_29","unstructured":"(Accepted 17 November 1983)"},{"key":"ref_30","unstructured":"Forty one patients with overdosage of maprotiline consecutively admitted to the intensive care units at Sahlgren's and East hospitals, Gothenburg, from January 1978 to May 1983 were included in the study. The diagnosis of overdosage of maprotiline was confirmed by the patient on recovery or by quantitative or qualitative toxicological analysis, or both. Coma grade was assessed using the scale of Matthew and Lawson,13 the most severe grade being recorded for each patient (grade 0, fully conscious; grade I, drowsy but obeys commands; grade II, unresponsive to commands but responds well to pain; grade III, unresponsive to commands and minimally responsive to pain; grade IV, completely unresponsive). Hypotension was defined as a systolic blood pressure < 90 mm Hg. Statistical analysis was made using the X2 test.","article-title":"Forty one patients with overdosage of maprotiline consecutively admitted to the intensive care units at Sahlgren's and East hospitals, Gothenburg, from January 1978 to May 1983 were included in the study. The diagnosis of overdosage of maprotiline was confirmed by the patient on recovery or by quantitative or qualitative toxicological analysis, or both. Coma grade was assessed using the scale of Matthew and Lawson,13 the most severe grade being recorded for each patient (grade 0, fully conscious; grade I, drowsy but obeys commands; grade II, unresponsive to commands but responds well to pain; grade III, unresponsive to commands and minimally responsive to pain; grade IV, completely unresponsive). Hypotension was defined as a systolic blood pressure < 90 mm Hg. Statistical analysis was made using the X2 test"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.288.6417.597","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.288.6417.597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T19:57:57Z","timestamp":1765396677000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.288.6417.597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,2,25]]},"references-count":30,"journal-issue":{"issue":"6417","published-online":{"date-parts":[[1984,2,25]]},"published-print":{"date-parts":[[1984,2,25]]}},"alternative-id":["10.1136\/bmj.288.6417.597"],"URL":"https:\/\/doi.org\/10.1136\/bmj.288.6417.597","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1984,2,25]]}}}