Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 2 1 2015 12 29 29 29 Taghi Baghdadi Department of Orthopedics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran Mahmoud Farzan Department of Orthopedics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran SM Javad Mortazavi Department of Orthopedics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran Nabi Ramezani Pirabadi Department of Orthopedics, Imam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, IR Iran Amir Reza Farhoud Department of Orthopedics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran 2019 07 18 Background: Osteomalacia represents a risk factor for hip fracture (HF), which is one of the most common and costly injuries in elderly. Objectives: This study was performed to determine the frequency of histopathologic and laboratory osteomalacia in elderly patients with HF. Patients and Methods: Totally, 87 patients with HF, admitted to Imam Khomeini hospital, Tehran, Iran, from 2005 to 2006, were studied. Laboratory investigations included serum calcium, phosphorus, alkaline phosphatase (ALP), albumin and 25-hydroxy vitamin D3 [25 (OH) D3]. Open biopsy from ipsilateral iliac crest was performed during the same surgery. Results: The average age was 78.06 ± 8.4 years. Bone biopsy showed osteomalacia in eight patients (9.2%), hypocalcaemia in 42.5%, hypophosphatemia in 17.2%, hypoalbuminemia in 66.6% and 25 (OH) D3 deficiencies in 66.6%. Concomitant hypophosphatemia and hypovitaminosis [25 (OH) D3 < 10 ng/mL] was detected in 13 patients (14.6%). An increased level of serum ALP was found in 52.8%. Five (38.5%) patients had only laboratory osteomalacia, when histopathological findings were negative. Conclusions: Elderly patients with femoral neck or intertrochanteric fractures may have osteomalacia, as a treatable cause for osteopenia, and laboratory tests may not be precise criteria for diagnosis in HF patients. https://jost.tums.ac.ir/index.php/jost/article/view/29 https://jost.tums.ac.ir/index.php/jost/article/download/29/29