Radiological study to determine the association of proximal femoral geometry in hip fractures

K. Sivaprasad; Rachna Patil

doi:10.18203/2320-6012.ijrms20230009

Authors

K. Sivaprasad Department of Orthopedics, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India
Rachna Patil Department of Orthopedics, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230009

Keywords:

Neck fracture, FNL, HAL, Extracapsular fractures, Intracapsular fractures, Femoral geometry

Abstract

Background: In literature there is scarcity of documentation to test the relationship of radiological geometry of proximal femur with incidence and patterns of hip fractures especially in Indian population. In this study radiological parameters like femoral neck length (FNL), hip axis length (HAL), neck shaft angle (NSA), femoral neck diameter (are measured in standardized digital pelvis radiograph of patients with hip fractures presented at a tertiary care hospital and efforts were made to establish a relationship of these parameters with the pattern of hip fractures in Indian population.

Methods: Total of 72 patients attending orthopaedics outpatient clinic or admitted into the hospital with proximal femoral fractures were included in the study. Thorough history and clinical examination data were obtained. Radiographs and necessary investigations were done and FNL, HAL, NSA was calculated. Analysis was done using SPSS package version 26.

Results: Among the 72 patients included in the study, the mean age of the patients is 65 years with a SD of 13.64. The mean FNL was 2.452 cm with a SD of 0.471. The mean HAL was 11.1547cm and SD of 1.062. The mean NSA was 124.56degree with a SD of 3.339. The distribution of NSA is statistically insignificant at p<0.05. The mean NSA of extracapsular fracture and Intracapsular fracture in 51-60 years is 123.1956 and 125.7750 with SD of 2.58782 and 3.99555 is respectively. The p=0.151 and is statistically significant.

Conclusions: In our study, we concluded that the HAL is significantly increased for intracapsular fractures than for Extracapsular fractures in old age group of 51-60 years. In our study, we could not establish any significant correlation between FNL, HAL and NSA in any age group for any fracture type.

Metrics

Metrics Loading ...

References

Koval KJ, Zuckerman JD. Hip fractures: I. Overview and evaluation and treatment of femoral-neck fractures. J Am Academy Orthop Surgeons. 1994;2(3):141-9.

Perry DC, Metcalfe D, Griffin XL, Costa ML. Inequalities in use of total hip arthroplasty for hip fracture: population-based study. BMJ. 2016;353.

Parker M, Johansen A. Hip fracture. BMJ. 2006;333(7557):27-30.

Morrissey N, Iliopoulos E, Osmani AW, Newman K. Neck of femur fractures in the elderly: does every hour to surgery count? Injury. 2017;48(6):1155-8.

Gnudi S, Ripamonti C, Gualtieri G, Malavolta N. Geometry of proximal femur in the prediction of hip fracture in osteoporotic women. Br J Radiol. 1999;72(860):729e33.

Pulkkinen P, Partanen J, Jalovaara P, Jämsä T. Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int. 2004;15(4):274-80.

Yang RS, Wang SS, Liu TK. Proximal femoral dimension in the elderly Chinese women with hip fractures in Taiwan. Osteoporos Int. 1999;10:109-14.

Sievänen H, Jozsa L, Pap I, Järvinen M, Järvinen TA, Kannus P et al. Fragile external phenotype of modern human proximal femur in comparison with medieval bone. J Bone Miner Res. 200;22(4):537-453.

Brownbill RA, Ilich JZ. Hip geometry and its role in fracture: what do we know so far? Curr Osteoporosis Rep. 2003;1(1):25-31.

Faulkner KG, Cummings SR, Black D, Palermo L, Glüer CC, Genant HK. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Mineral Res. 1993;8(10):1211-7.

Gregory JS, Aspden RM. Femoral geometry as a risk factor for osteoporotic hip fracture in men and women. Med Engineering Physics. 2008;30(10):1275-86.

Mikhail MB, Vasuvani AN, Aloia JF. Racial differences in femoral dimensions and their relationship to hip fractures. Osteoporosis Int. 1996;6(1):22-4.

Geusen P; geometric characteristics of the proximal Femur and hip fractures risk. Osteoporos Int 1996;6(3):27-30.

Michellotti J, Clark J. Femoral neck length and hip fracture risk, Jbone Miner Res. 1999;14(10):1714-20.

Patel A, Gandhi M. A radiological study of proximal femoral geometry and its relationship with hip fractures in Indian population. Int J Orthop Sci. 2021;7(2):428-35.

Thirunthaiyan MR, Mukherjee K, Prashanth TK, Kumar DR. Predicting the Anatomical Location of Neck of Femur Fractures in Osteoporotic Geriatric Indian Population. Malaysian Orthop J. 2022;16(1):103.