Document Type : Original Article
Authors
1
Clinical Instructor, Community Health Nursing, Faculty of Nursing, University of Damanhour
2
Professor of Epidemiology, Epidemiology Department, High Institute of Public Health, University of Alexandria
3
Professor of Health Education and Behavioral Science, Department of Health Administration and Behavioral Science, High Institute of Public Health, University of Alexandria
4
Professor of Orthopedic Surgery, Faculty of Medicine, University of Alexandria
Abstract
Background: Osteoporotic vertebral and femoral neck fractures are major public health
concerns, particularly in aging populations, due to their rising incidence and associated
healthcare 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 was
conducted at El-Hadara University and Ras El Tin Hospitals. The study enrolled 384
patients with confirmed vertebral or femoral neck fractures and 384 age- and sex-matched
controls 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 fracture
occurrence. Results: Advanced age (≥60 years), low education, unemployment, and rural
residence significantly increased fracture risk (p < 0.001). A family history of osteoporosis
or fractures was more common among cases (p < 0.001). Behavioral factors such as
smoking, insufficient physical activity, and limited sun exposure were significantly
associated with fractures (p < 0.001). Nutritional inadequacies—including low calcium,
vitamin D, and protein intake—were markedly higher in cases (p < 0.001). Chronic
conditions (osteoporosis, diabetes, hypertension, Parkinson’s disease) and prolonged
corticosteroid use further elevated risk (p < 0.05). Conclusions: Fracture risk in Alexandria
is multifactorial, influenced by sociodemographic vulnerabilities, modifiable lifestyle and
nutritional behaviors, genetic predisposition, chronic diseases, and medications.
Recommendations: Prevention should emphasize education, smoking cessation, physical
activity, sun exposure, improved nutrition, fracture risk screening, liaison services, and
rural outreach to enhance bone health equity.
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