Hip Pelvis.  2012 Jun;24(2):102-108. 10.5371/hp.2012.24.2.102.

Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females

  • 1Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea. hyeonjun@dau.ac.kr


To analyze, by radiograph, the difference in bone mineral density (BMD) and the proximal femoral morphology of females who are over 65 years old and have had either an intertrochanteric fracture or a femoral neck fracture.
One hundred twenty-five females over 65 years of age with femoral neck fractures or intertrochanteric fractures were examined for bone mineral density using computed tomography from April 2008 to March 2011. The bone mineral density was measured by dual-energy x-ray absorptiometry (DEXA). The morphology of the proximal femur was also measured by computed tomography in the unaffected hip.
In the femoral neck fracture group, the mean BMD value was 0.563 g/cm2 in the femoral neck region and 0.753 g/cm2 in the intertrochanteric region. In the intertrochanteric fracture group, the mean BMD value was 0.457 g/cm2 in the femoral neck region and 0.656 g/cm2 in the intertrochanteric region. There are statistically significant differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.029, 0.030). The mean cortical index was 0.59 in the femoral neck fracture group and 0.51 in the intertrochanteric fracture group. There are statistical differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.001).
The BMD of the proximal femoral neck and intertrochanteric regions of the intertrochanteric fracture group were significantly lower than that of the femoral neck fracture group. The cortical index was also significantly lower in the intertrochanteric fracture group than the femoral neck fracture group. BMD and computed tomography seem useful to check in women older than 65 who have fractures of the proximal femur.


Femoral neck fracture; Intertrochanteric fracture; Bone mineral density; Cortical index

MeSH Terms

Absorptiometry, Photon
Bone Density
Femoral Neck Fractures
Femur Neck
Hip Fractures


  • Fig. 1 Measurement made on computed tomography of morphologic features of the hip. Hip axis length defined as the length of head axis from the lateral aspect of the greater trochanter to the inner pelvic rim (AE), femoral neck axis length defined as the length of neck axis between the head center and the femoral medullary axis (BF), neck-shaft angle defined as the angle between femur shaft axis and femur neck axis (AFG), head offset defined as the length of head center from axis of femoral shaft. (BB').

  • Fig. 2 Cortical index defined as the ratio between the cortex diameter of the proximal femur and the total diameter of the proximal femur (Cortical index = (I-H)/I).


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