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Comparison of morphological features in the femur between femoral neck fractures and femoral intertrochanteric fractures

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Abstract

Purpose

The purpose of this study is to make proximal femur fracture types more predictable by considering morphological features of an acetabulum as well as of a proximal femur in the Japanese population.

Methods

A retrospective review of radiographs of the proximal femoral fractures was conducted in patients registered from 2010 to 2012, dividing into patients with femoral neck fractures; Group Neck (n = 101), and patients with femoral intertrochanteric fractures; Group IT (n = 99). Intergroup comparison was conducted: age, sex, height, weight, the ratios of femoral intertrochanteric length (IT Length), femoral neck length (Neck Length), femoral neck width (Neck Width), lateral offset length (Offset) to femoral head diameter, neck–shaft angle (N–S angle), and center–edge angle of the acetabulum (C–E angle), adjusting for age. Multiple logistic regression analysis was conducted among these parameters.

Results

The Group IT showed significantly older age than the Group Neck. Greater C–E angle in Group IT was observed in the patients in their 80s and 90s years of age. The Group Neck showed greater N–S angle only in the patients in their 80s years of age. In multiple logistic regression analysis, the impact of the age and the C–E angle on the fracture types was similar (odds ratio 1.08, 1.09, respectively, p < 0.01 both).

Conclusions

Age, N–S angle, and C–E angle could be independent predictors for determining the proximal femur fracture types.

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References

  1. Duboeuf F, Hans D, Schott AM, Kotzki PO, Favier F, Marcelliet C (1997) Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: the EPIDOS Study. J Bone Miner Res 12:1895–1902

    Article  CAS  PubMed  Google Scholar 

  2. Ferris BD, Kennedy C, Bhamra M, Muirhead-Allwood W (1989) Morphology of the femur in proximal femoral fractures. J Bone Joint Surg Br 71:475–477

    CAS  PubMed  Google Scholar 

  3. Gluer CC, Cummings SR, Pressman A, Li J, Gluer K, Faulkner KG, Grampp S (1994) Prediction of hip fractures from pelvic radiographs: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 9:671–677

    Article  CAS  PubMed  Google Scholar 

  4. Gnudi S, Ripamonti C, Lisi L, Fini M, Giardino R, Giavaresi G (2002) Proximal femur geometry to detect and distinguish femoral neck fractures from trochanteric fractures in postmenopausal women. Osteoporos Int 13:69–73

    Article  CAS  PubMed  Google Scholar 

  5. Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9:1889–1894

    Article  CAS  PubMed  Google Scholar 

  6. Greenspan SL, Myers ER, Kiel DP, Parker RA, Hayes WC, Resnick NM (1998) Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med 104:539–545

    Article  CAS  PubMed  Google Scholar 

  7. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA (1993) Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 52:192–198

    Article  CAS  PubMed  Google Scholar 

  8. Kok LM, van der Steenhoven TJ, Nelissen RG (2011) A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures. Int Orthop 35:1545–1551

    Article  PubMed  Google Scholar 

  9. Mautalen CA, Vega EM, Einhorn TA (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone 18:133–137

    Article  Google Scholar 

  10. Pande I, O’Neill TW, Pritchard C, Scott DL, Woolf AD (2000) Bone mineral density, hip axis length and risk of hip fracture in men: results from the Cornwall Hip Fracture Study. Osteoporos Int 11:866–870

    Article  CAS  PubMed  Google Scholar 

  11. Partanen J, Jamsa T, Jalovaara P (2001) Influence of the upper femur and pelvic geometry on the risk and type of hip fractures. J Bone Miner Res 16:1540–1546

    Article  CAS  PubMed  Google Scholar 

  12. Pulkkinen P, Partanen J, Jalovaara P, Jamsa T (2004) Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int 15:274–280

    Article  PubMed  Google Scholar 

  13. Rafferty KL (1997) Structural design of the femoral neck in primates. J Hum Evol 34:361–383

    Article  Google Scholar 

  14. Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113:366–374

    Article  CAS  PubMed  Google Scholar 

  15. Sawalha S, Parker MJ (2012) Characteristics and outcome in patients sustaining a second contralateral fracture of the hip. J Bone Joint Surg Br 94:102–106

    Article  CAS  PubMed  Google Scholar 

  16. Stewart A, Porter RW, Primrose WR, Walker LG, Reid DM (1999) Cervical and trochanteric hip fractures: bone mass and other parameters. Clin Rheumatol 18:201–206

    Article  CAS  PubMed  Google Scholar 

  17. Szulc P, Duboeuf F, Schott AM, Dargent-Molina P, Meunier PJ, Delmas PD (2006) Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int 17:231–236

    Article  CAS  PubMed  Google Scholar 

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Each author certifies that they have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

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Correspondence to Koun Yamauchi.

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Each author certifies that they have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

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Yamauchi, K., Naofumi, M., Sumida, H. et al. Comparison of morphological features in the femur between femoral neck fractures and femoral intertrochanteric fractures. Surg Radiol Anat 38, 775–780 (2016). https://doi.org/10.1007/s00276-016-1626-9

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  • DOI: https://doi.org/10.1007/s00276-016-1626-9

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