Risk Factors Associated with Osteoporotic Vertebral and Neck of Femur Fractures: A Hospital-Based Case-Control Study in Alexandria

Abstract

Background: Osteoporotic vertebral and femoral neck fractures are major public healthconcerns, particularly in aging populations, due to their rising incidence and associatedhealthcare burden. Objective: To investigate sociodemographic, behavioral, nutritional,familial, and medical determinants of vertebral and femoral neck fractures in Alexandria,Egypt. Subjects and Method: A hospital-based matched case–control study wasconducted at El-Hadara University and Ras El Tin Hospitals. The study enrolled 384patients with confirmed vertebral or femoral neck fractures and 384 age- and sex-matchedcontrols without fractures. Data collection encompassed sociodemographic indicators,family history, lifestyle practices, dietary intake, comorbidities, and medication use.Statistical analyses assessed associations between potential risk factors and fractureoccurrence. Results: Advanced age (≥60 years), low education, unemployment, and ruralresidence significantly increased fracture risk (p < 0.001). A family history of osteoporosisor fractures was more common among cases (p < 0.001). Behavioral factors such assmoking, insufficient physical activity, and limited sun exposure were significantlyassociated with fractures (p < 0.001). Nutritional inadequacies—including low calcium,vitamin D, and protein intake—were markedly higher in cases (p < 0.001). Chronicconditions (osteoporosis, diabetes, hypertension, Parkinson’s disease) and prolongedcorticosteroid use further elevated risk (p < 0.05). Conclusions: Fracture risk in Alexandriais multifactorial, influenced by sociodemographic vulnerabilities, modifiable lifestyle andnutritional behaviors, genetic predisposition, chronic diseases, and medications.Recommendations: Prevention should emphasize education, smoking cessation, physicalactivity, sun exposure, improved nutrition, fracture risk screening, liaison services, andrural outreach to enhance bone health equity.