{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:04:36Z","timestamp":1789362276843,"version":"build-2803163510"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hip fractures represent a significant clinical and public health challenge in the elderly, particularly as populations age globally. While low-energy falls are the primary mechanism of injury, the specific risk factors differentiating intra-capsular and extra-capsular hip fractures remain inadequately characterized. Existing research has largely focused on general fracture risks, leaving a gap in understanding how geometric, nutritional, and metabolic parameters distinctly influence fracture type. Elucidating these differences is essential for advancing personalized prevention in vulnerable aging populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to identify and compare risk factors associated with intra-capsular and extra-capsular hip fractures among elderly patients following low-energy falls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted involving 636 patients aged 70 years or older with hip fractures. Demographic characteristics, geometric parameters (including neck-shaft angle, cortical index, and Singh index), and biochemical markers (hemoglobin, albumin, total protein, and fasting blood glucose) were evaluated. Multivariable logistic regression was employed to identify predictors of fracture type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with extra-capsular fractures were significantly older and exhibited lower hemoglobin levels, albumin, total protein, cortical index, and neck-shaft angles, along with higher fasting blood glucose compared to those with intra-capsular fractures (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The logistic regression model identified cortical index, neck-shaft angle, hemoglobin, and fasting blood glucose as significant independent predictors of fracture type.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extra-capsular hip fractures are associated with poorer nutritional status, reduced bone density, smaller neck-shaft angle, and higher blood glucose levels. These findings suggest that extra-capsular fractures are differentially associated with poorer nutritional status, reduced cortical thickness, smaller neck-shaft angles, and higher glucose levels. Our results provide preliminary evidence that combined assessments may aid in risk stratification; however, these associations warrant confirmation in prospective cohort studies before clinical translation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1753069","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:37:15Z","timestamp":1789360635000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with intracapsular versus extracapsular hip fracture patterns in elderly patients following low-energy falls: a retrospective analysis from a single tertiary-care center in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Si-Jia","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The Affiliated Hospital of Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]},{"name":"Department of Orthopedics, The First People\u2019s Hospital of Shangqiu","place":["Shangqiu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong-Shuai","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Affiliated Hospital of Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Xin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Affiliated Hospital of Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The Affiliated Yixing Hospital of Jiangsu University","place":["Wuxi, Jiangsu, China"]},{"name":"Regenerative Medicine & Tissue Engineering Research Center, Institute of Medical Innovation and Translation, The Affiliated Yixing Hospital of Jiangsu University","place":["Yixing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Chun","family":"Zha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Affiliated Hospital of Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e2512689","DOI":"10.1001\/jamanetworkopen.2025.12689","article-title":"Risk analysis index for estimation of 30-day postoperative mortality in hip fractures","volume":"8","author":"Gupta","year":"2025","journal-title":"JAMA Netw Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1007\/s00198-021-05849-y","article-title":"Current status and distribution of hip fractures among older adults in China","volume":"32","author":"Gong","year":"2021","journal-title":"Osteoporos Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e081250","DOI":"10.1136\/bmj-2024-081250","article-title":"Advances in the management of osteoporosis","volume":"390","author":"Hoong","year":"2025","journal-title":"Br Med J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"105832","DOI":"10.1016\/j.archger.2025.105832","article-title":"Global, regional, and national burdens of hip fractures in elderly individuals from 1990 to 2021 and predictions up to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"133","author":"Tian","year":"2025","journal-title":"Arch Gerontol Geriatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1016\/j.arth.2013.10.021","article-title":"Early operative intervention is associated with better patient survival in patients with intracapsular femur fractures but not extracapsular fractures","volume":"29","author":"Steinberg","year":"2014","journal-title":"J Arthroplasty"},{"key":"B6","doi-asserted-by":"publisher","first-page":"21514593251345390","DOI":"10.1177\/21514593251345390","article-title":"Does fracture type or surgical technique influence mortality in elderly hip fracture patients?","volume":"16","author":"G\u00fcnayd\u0131n","year":"2025","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2524","DOI":"10.4103\/0366-6999.244118","article-title":"Comparison of proximal femoral geometry and risk factors between femoral neck fractures and femoral intertrochanteric fractures in an elderly Chinese population","volume":"131","author":"Hu","year":"2018","journal-title":"Chin Med J (Engl)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.injury.2019.12.019","article-title":"Fat distribution may predict intra- or extra-capsular hip fracture in geriatric patients after falling","volume":"51","author":"Cheng","year":"2020","journal-title":"Injury"},{"key":"B9","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s13018-023-03559-1","article-title":"Influence of femoral bowing on stress distribution of the proximal femur: a three-dimensional finite element analysis","volume":"18","author":"Kaku","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jor.2021.02.012","article-title":"CCD angle & hip fractures - predictor of fracture symmetry?","volume":"24","author":"Thalmann","year":"2021","journal-title":"J Orthop"},{"key":"B11","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1177\/11207000211013029","article-title":"The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model","volume":"32","author":"Tu","year":"2022","journal-title":"Hip Int"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1111020","DOI":"10.3389\/fbioe.2023.1111020","article-title":"2D-3D Reconstruction of the proximal femur from DXA scans: evaluation of the 3D-shaper software","volume":"11","author":"Dudle","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/os.13537","article-title":"The impact of coronal configuration of the proximal femur on its mechanical properties and the validation of a new theoretical model: finite element analysis and biomechanical examination","volume":"15","author":"Zhang","year":"2023","journal-title":"Orthop Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2468","DOI":"10.1210\/jc.2016-1099","article-title":"Association of hypoalbuminemia with osteoporosis: analysis of the national health and nutrition examination survey","volume":"101","author":"Afshinnia","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1007\/s00198-023-06837-0","article-title":"Drug utilization analysis of osteoporosis medications in seven European electronic health databases","volume":"34","author":"Tan","year":"2023","journal-title":"Osteoporos Int"},{"key":"B16","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1177\/2151458517729615","article-title":"\u201cHidden\u201d preoperative blood loss with extracapsular versus intracapsular hip fractures: what is the difference?","volume":"8","author":"Harper","year":"2017","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"B17","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1007\/s11914-016-0332-1","article-title":"Advanced glycation end products, diabetes, and bone strength","volume":"14","author":"Yamamoto","year":"2016","journal-title":"Curr Osteoporos Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1753069\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:37:25Z","timestamp":1789360645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1753069\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":17,"alternative-id":["10.3389\/fmed.2026.1753069"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1753069","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"article-number":"1753069"}}