Changing prevalence of osteomalacia in hip fractures in southeast Scotland over a 20-year period.

In a randomized study of 81 patients with fresh hip fractures who underwent bone biopsy at the time of surgery there was no histologically detectable osteomalacia. This represented a fall in prevalence since a similar study 20 years previously had shown a 12 per cent incidence in the same population. The implications for routine histological screening and measurement of serum bone biochemistry in patients with hip fractures is discussed. The majority of patients in the study group had histologically detectable osteoporosis suggesting that this was an important factor in the aetiology of femoral neck fractures.