ANALYSIS OF SINGH’S INDEX FOR OSTEOPOROSIS IN PATIENTS WITH NECK OF FEMUR AND INTERTROCHANTERIC FRACTURE: AN AMBISPECTIVE OBSERVATIONAL STUDY

Abstract

The Singh Index is a radiographic evaluation of the architecture of the proximal femur, but its role in hip fracture patients is still unclear. This study aimed to determine the Singh's Index grades and their correlation with demographic factors and fracture pattern. A total of 77 patients (40 years old or older) with low-energy fractures of the femoral neck or intertrochanteric region were recruited for an ambispective observational study. The contralateral unfractured proximal femur was compared with Singh's Index on AP pelvis X-rays. Grade distributions and associations with age, sex, comorbidities, and fracture pattern were analyzed. Grade III predominated (51.95%), followed by Grade II (28.57%), Grade IV (18.18%), and Grade V (1.30%). No patients had Grade I or VI. The number of women who participated was 57.14% and the proportion of more than 60 years was 83.12%. Intertrochanteric fractures were the most common type of fracture, representing 70.13% of injuries. In reported analyses, no association between Singh's Index grade and age, sex, comorbidity category, and fracture pattern were statistically significant. The most frequent radiographic classification was III and did not differ significantly between the subgroups studied. The Index proposed by Singh may be helpful to describe trabecular patterns observed on routine radiographs, but caution is advised when using it for diagnostic interpretation, and it needs additional densitometric validation. The small sample size and small numbers in each category further restrict inferences.