Usefulness of the Singh Index in Predicting Hip Fracture Patterns in Older Adults: A Retrospective Study in A Second Level Hospital

Abstract

Introduction: The elderly population has increased in recent years, leading to a rise in age-related diseases. Hip fractures are particularly noteworthy, as over 90% of patients in the Traumatology and Orthopedics service are over 65 years old. General Objective: To determine the usefulness of the Singh index in hip fractures in adults over 65 years of age at Regional General Hospital No. 1 Orizaba, and to identify related risk factors. Methods: A retrospective, cross-sectional, descriptive, observational study was conducted. The study population consisted of 129 patients hospitalized in the Traumatology and Orthopedics Service between January 2023 and December 2024 at Regional General Hospital No. 1 in Orizaba, Veracruz. Results: Of the 129 patients, 63.16% (84 patients) presented with transtrochanteric fractures, with a higher incidence in women (64 cases, 64.6%) and in patients over 75 years of age (94 patients, 72.86%). A statistically significant correlation was found between the Singh index and the anatomical location of the fracture (r = -0.39, p < 0.001), suggesting that greater trabecular bone loss is associated with intracapsular fractures. Conclusions: The Singh index showed a statistically significant association with hip fracture type in older adults, and therefore can be considered a useful tool as an indirect estimator of bone quality in resource-limited clinical settings. However, its value should be interpreted with caution due to its methodological limitations. Level of evidence: III (retrospective analytical observational study).