J Bone Metab.  2016 Aug;23(3):175-182. 10.11005/jbm.2016.23.3.175.

Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture

• Han J
• Hahn MH

• KMID: 2350814
• DOI: http://doi.org/10.11005/jbm.2016.23.3.175

Abstract

BACKGROUND
Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD.
METHODS
This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed.
RESULTS
There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD.
CONCLUSIONS
We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD.

Keyword

Femoral neck fracture; Hip fractures; Osteoporosis; Risk factors

MeSH Terms

Absorptiometry, Photon
Bone Density
Continental Population Groups
Female*
Femoral Neck Fractures
Femur
Femur Neck
Hip Fractures
Hip*
Humans
Neck
Odds Ratio
Osteoporosis
Risk Factors*

Figure

• 

  Fig. 1 Parameters of proximal hip geometry: Hip axis length (HAL): distance form greater trochanter to inner pelvic brim (mm). Cross-sectional area (CSA): CSA of mid neck portion (mm2). D1: Distance along the neck axis from the center of the femoral head to the section of minimum CSA (mm). D2: Distance from the center of the femoral head to the shaft axis (mm). Neck diameter: the width of neck (mm). Neck shaft angle: the angle between the femoral neck axis and the shaft axis (degree). ROI, region of interest; CSMI, cross-sectional moment of inertia.

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