الفهرس 
Dietary factors
Conservative measuresOnly 14 pages are availabe for public view
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Abstract
Fractures are important public health problem through its association with high rates of morbidity, mortality and disabilities furthermore increasing burden of cost.
The study was conducted to fulfill the following aims
General objective:
To identify the risk factors of vertebral and neck of the femur fractures.
Specific objective
• To study sociodemographic, familial, medical, environmental and behavioral factors related to vertebral, neck of femur fractures.
• To assess knowledge and practices of the patients related to vertebral and femur fractures.
The study was conducted in three phases
I- Preparatory phase
During the preparatory phase, literature was reviewed and study tool were prepared, preparatory educational courses were taken and pilot study was carried out.
II- Operational phase
Hospital based matched case-control study was carried out 384 cases and 384 controls over a period of twelve months from September 2006 to end of October 2007 in the outpatient of orthopaedic department of El-Hadara University Hospital in Alexandria and the outpatient of the orthopaedic department of Ras El-Teen Hospital.
Data was collected from the patients and their controls through
1- Interviewing questionnaire included:
a- Personal and demographic data including name, age, sex, residence.
b- Socio-demographic data including Education and occupation.
c- Data about suspected risk factors or protective factors such as: smoking, low calcium intake, history of disabilities osteoporosis, bronchial asthma a sedentary life style family history of pathological fractures, and family history of (LBP) analgesics use, not following a diet and alcohol.
2- Review of medical records for each patient and control to obtain information about.
a- Laboratory investigation
The sample of cases and control were investigated for fasting blood sugar F.B.S and serum creatinine only.
b- Plain x-ray of fractures.
1- X-ray lumbo-sacral spine.
2- X-ray both hip Joint Anterior-Posterior A-P View.
III- A stastical analysis phase
Completeness and accuracy of the collected data was regularly checked in the same day of collection by investigator. The statistical analysis was done using the statistical package for the social sciences, version 10 (SPSS, 2000) and EPI-Info version 6.4 Descriptive statistics including mean and standard deviation were performed and used in presentation of tabular forms of data. Chi-square test was used for comparison of differences in proportions for categorical variable at as percent level of significance. Adds ratio, multiple logistic regression were used.
The results of the study
Could be summarized in the following items:
1- Age range for sample was from 18 to 70 years. Mean age for fractures cases 47 ± 16 years.
2- Regarding the education level, 38.5% of cases were illiterate versus 18% of the controls on the other hand, 9.4% of fractures cases had university degree compared to 31.3% of the controls.
3- The professional represent 6.5% of cases in comparison with 19% in controls. Most of females in this study were house wives either cases 33.8% or controls. 31.5%.
4- The study recorded that the mean history of calcium intake was 1000.18 among fractures cases while in controls it was 1493.2% with statistical significant as t = 14.23. P<0.0001.
5- The study shows that 31.0% of cases were osteoporotic compared with 1.08% in control group, with statistical difference (X2 MH 33.49 = , P = < 0.001).
6- Also 31% of fractures cases, 43.5 % of controls suffering from asthma with statistical significant difference (X2 MH= 4.40 , P<0.036).
7- Diabetes mellitus was higher in cases 27.3% than controls 13.0% with statistical significant difference. X2MH 7.38, P= 0.007
8- The study also revealed that history of familial (LBP) was higher in cases 59.1% than controls 26.6% with statistical difference as X2 MH= 82.98 , P<0.000).
9- The present study revealed that practice exercise had a protective effect on fractures formation.
10- The study shows that 50.3% of fractures cases were current smokers and 43.5% of smoker cases were heavy smokers (smoking more than 30 packets per year compared to only 19.7% heavy smokers among controls with statistical significant differences X2 MH= 92.29 P=0.0001).
11- The study revealed that fractures occurred mainly in the street (62.5%), while the percentage of this fractures were at home 37.5% either in the bathroom (58.3%), bedroom (0.7%), living Room ( 10.4%) stairs (22.7%) and kitchen (4.9%) also the study shows that (51.0%) of fractures occurred at after noon period.
12- The study revealed that the knowledges of controls were better than the knowledges of cases in the majority of question. The study shows that percentage of femur fractures was 70.8% while vertebral fractures No. was 29.2%.
from all the above findings, it can be concluded that low calcium intake, smoking, family history of low back pain LBP , a sedentary life style, history of chronic diseases, family history of pathological fractures, history of disabilities were significant risk factors for vertebral & femur fractures formation, while practice exercise has protective effect on fractures formation.
The following are the main recommendation suggested from the study:
Recommendations of the study:
1- Health education and health promotion programs for prevention of osteoporosis and vertebral and femur fractures.
a- Educational messages should cover the following items.
- Healthy life style.
- Smoking cessation.
- Dietary modifications (healthy diet intake calcium and vitamin D essential for bone health.
- Physical exercise-sunlight exposure especially in early morning and before sun set.
- Maintain health body weight.
- Periodic vision check up especially for old age.
- Accident prevention and home safety.
b- Increasing public awareness about fractures through mass media of communications.
c- Educational materials eg. written handouts, booklets posters, leaflets should be available at health clinic to provide patients with necessary information regarding osteoporosis and its prevention.
2- Health care professionals roles:
a- Help to identify individuals at high risk of osteoporosis and early screening through performing bone density test.
b- Assist in prevention and management of osteoporosis by prescribed life style measures to prevent bone loss.
c- Refer patients to appropriate investigation. Health care provider should be aware of possible side effects especially cortisone therapy for longer than 3 months. Health care provider should be given preventive treatment provide with clear instruction verbal and written to the patient emphasize in long nature of treatment of osteoporosis.