This study aims to better understand the factors that increase the risk of a special type of hip fracture in older women, known as intertrochanteric femoral fractures with lateral wall involvement. Hip fractures are very common in elderly patients, especially in women after menopause, and can seriously affect independence, mobility, and quality of life.

Between January 2023 and February 2024, postmenopausal women who were admitted with intertrochanteric femoral fractures were studied. Among them, some patients had fractures only in the main hip area, while others had additional involvement of the lateral wall, an important supportive structure of the hip. Researchers collected information such as age, body mass index (BMI), bone mineral density (BMD), and bone metabolism markers.

The study found that women with lower BMI and lower bone mineral density at the hip and lumbar spine were more likely to have lateral wall involvement in their fractures. Age and blood markers of bone metabolism did not show a strong link.

Understanding these risk factors can help doctors improve preoperative evaluation, choose better surgical strategies, and recommend preventive measures such as bone health management and fall prevention. This may ultimately reduce complications, improve recovery, and support better long-term outcomes for elderly women with hip fractures.

Inclusion Criteria:

Postmenopausal women diagnosed with intertrochanteric femoral fractures.

History of low-energy trauma (e.g., fall from standing height).

Treated surgically with proximal femoral nail antirotation (PFNA) device, with or without lateral wall plate fixation.

Availability of complete demographic and clinical data (age, height, weight, bone mineral density, and bone turnover markers).

Eligible for retrospective case-control analysis.

Exclusion Criteria:

High-energy trauma (e.g., motor vehicle accidents).

Severe systemic comorbidities such as hepatic or renal failure, bone tumors, or endocrine disorders (e.g., hyperparathyroidism).

Use of medications affecting bone metabolism within 6 months before surgery.

Diagnosis of diabetes mellitus.

History of chronic smoking or alcohol abuse.

Inability to provide accurate anthropometric data (height and weight).

The study population consisted of postmenopausal women admitted to the Department of Orthopedics at the Second Affiliated Hospital of Soochow University between January 2023 and February 2024 with a diagnosis of intertrochanteric femoral fracture. A total of 49 patients were included after applying eligibility criteria. Of these, 29 had isolated intertrochanteric fractures and 20 had intertrochanteric fractures with concomitant lateral wall involvement. All patients underwent surgical fixation with proximal femoral nail antirotation (PFNA), with or without additional lateral wall plate fixation, according to clinical indications.