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Influence of the Upper Femur and Pelvic Geometry on the Risk and Type of Hip Fractures
Author(s) -
Partanen Juha,
Jämsä Timo,
Jalovaara Pekka
Publication year - 2001
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.2001.16.8.1540
Subject(s) - medicine , femur , hip fracture , radiography , femoral neck , fracture (geology) , orthodontics , trochanter , greater trochanter , lesser trochanter , nuclear medicine , surgery , osteoporosis , geology , geotechnical engineering
The geometry of the upper femur has been reported to associate with the hip fracture risk in postmenopausal women. However, these associations seem to be partly conflicting, probably because of differences in measurement setup. Here, we compared the upper femur and pelvic geometries of 70 hip fracture patients (46 cervical and 24 trochanteric fractures) and 40 age‐adjusted controls based on plain anteroposterior radiographs, eliminating the possible sources of inaccuracy as far as possible by using a standardized patient position and calibrated dimension measurements by digital image analysis. The femoral neck/shaft angle (NSA) was larger in the fracture patients compared with the controls ( p < 0.001). The fracture group had thinner cortices in the upper femur than the controls ( p < 0.001). The femoral shaft diameter (FSD; p < 0.001), trochanter width (TW; p < 0.01), and the pelvic dimensions, that is, the smallest outer pelvic diameter (SOPD; p < 0.01) and the largest inner pelvic diameter (LIPD; p < 0.05) were smaller in the fracture group. Comparing the fracture types, we found NSA larger in the cervical hip fracture patients than in the patients with a trochanteric fracture ( p < 0.01). The femoral neck/shaft cortex ratio was lower and the FSD was smaller in the cervical hip fracture group ( p < 0.05). Acetabular width (AW) was greater and the SOPD was wider in the cervical fracture patients ( p < 0.01). We concluded that the upper femur and pelvic dimensions as defined from calibrated and position‐standardized plain radiographs are useful in the evaluation of hip fracture risk and fracture type.