Prevalence of osteoporosis in India: an observation of 31238 adults

Background: Aim of the study was to determine the prevalence of bone loss (both osteopenia and osteoporosis) at national and regional levels in India.Methods: In this retrospective study, data obtained from in-clinic screening camps conducted for bone loss was analysed. Participants were apparently healthy adults (aged 18 years and above) evaluated for bone mineral density (BMD) using calcaneal quantitative ultrasound (QUS) of left foot. Based on t score of BMD obtained, participants were labelled as normal (T-score <-1 SD), osteopenia (t score-1 to -2.5 SD) and osteoporosis (t score <-2.5 SD).Results: In total, data of 31238 participants was analysed retrospectively. Mean age was 47.8±14.2 years and 47.6% were females. Among females, 38.8% were postmenopausal women (age >50 years). Overall prevalence of osteopenia and osteoporosis was 49.9 and 18.3% respectively. Across East, West, North and South India, the prevalence of osteopenia was 51.3, 47.9, 55.6 and 47.4% respectively whereas prevalence of osteoporosis was 18.4, 16.3, 16.4 and 20.7% respectively. Prevalence of osteoporosis was slightly higher in females than males (19.4 vs 17.3%). Among postmenopausal women, overall osteoporosis prevalence was 33.1% and ranged from 16.9% in North region to 21.8% South region. Prevalence of osteoporosis (37.0 vs 12.5%) was higher in elderly (≥60 years) than adults (<60 years).Conclusions: Among adults, nearly one out of two have osteopenia and one out of five have osteoporosis. Osteoporosis prevalence was higher in the women and in the elderly. Nearly one out of three women in postmenopausal age group have osteoporosis. There is no substantial difference across the four regions of the country. Considering the significant prevalence of low BMD, there is need to increase the awareness about bone health in general population. 

Role of gamma nail in management of pertrochanteric fractures of femur

<b>Background:</b> Pertrochanteric fractures which involve trochanteric fractures with varying fracture geometry pose a significant challenge to the treating orthopedic surgeon. The aim of this study is to evaluate the management of pertrochanteric fractures of the femur using gamma nail [Asia pacific (AP)]. <b> Materials and Methods:</b> Sixty patients of pertrochanteric fractures were treated by closed reduction internal fixation by gamma nail from 1 January 1993 to 31 December 2000. Four patients were lost to follow-up. The remaining 56 patients were followed for a mean period of 3.2 years (range 2-4 years).The results were evaluated by assessing the patients regarding their clinical and functional outcome at follow-up as per Kyle&#x2032;s criteria. <b> Results:</b> Peroperative jamming of nail (<i> n</i> = 1), failed distal locking (<i> n</i> = 1), superior cut out of lag screw (<i> n</i> = 1) and postoperative varus malreduction (<i> n</i> = 1) were the complications observed. End results were excellent in 46.34&#x0025;, good in 36.58&#x0025;, fair in 14.64&#x0025;, poor in 2.43&#x0025;. <b> Conclusion:</b> Gamma nail in expert hands is a suitable implant for management of pertrochanteric fractures of the femur