Femoral Neck Axis Length, Height Loss and Risk of Hip Fracture in Males and Females

Objective: This study was conducted to investigate the risk of hip fracture using proximal femoral morphometry in fractured and nonfractured postmenopausal women.Methods: We conducted an observational cross-sectional study with 138 postmenopausal women (49 fractured and 89 nonfractured). The hip axis length (HAL), femoral neck axis length (FNAL), acetabular width (AW), femoral head width (FHW), femoral shaft width (FSW), and femoral neck shaft angle (FNSA) were measured in all cases by dual energy X-ray absorptiometry. We also studied the correlation between body mass index (BMI) with all the parameters in fractured and control groups.Results: The mean age, height, weight, and BMI were 61.24±3.23, 163.94±7.84 cm, 71.88±9.14 kg, and 26.72±2.78 kg/m², respectively, in fractured patients. In nonfractured patients the values were 59.73±5.32, 161.73±4.25 cm, 69.54±6.25 kg, and 26.74±2.23 kg/m² respectively. The mean HAL, FNAL, AW, FHW, FSW, and FNSA were 130.5±3.18 mm, 111.26±3.64 mm, 18.2±1.91 mm, 53.46±1.51 mm, 37.45±1.82 mm, and 132.76±3.15 degree incase group and 130.84±4.74 mm, 112.48±4.08 mm, 17.57±2.32 mm, 53.4±1.86 mm, 35.29±1.82 mm, and 128.76±3.6° in control group, respectively.Conclusion: The femoral parameters such as HAL, FNAL, AW, and FHW do not indicate any correlation between fractured and control groups, whereas FSW and FNSA were significantly higher in case group. The FNSA was having significant negative correlation with BMI in fractured group while that was having a significant positive correlation in the nonfractured group. This observation will be helpful in exploration of its clinical significance in proximal femoral fracture.Keywords: Proximal femur, Morphometry, Postmenopausal, Fracture.

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The Use of Femoral Neck Axis Length to Estimate Sex and Ancestry

Journal of Forensic Sciences ◽

10.1111/1556-4029.12820 ◽

2015 ◽

Vol 60 (5) ◽

pp. 1300-1304 ◽

Cited By ~ 13

Author(s):

Rebecca A. Meeusen ◽

Angi M. Christensen ◽

Joseph T. Hefner

Keyword(s):

Femoral Neck ◽

Femoral Neck Axis ◽

Axis Length

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Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

International Journal of Anatomy and Research ◽

10.16965/ijar.2021.140 ◽

2021 ◽

Vol 9 (3.1) ◽

pp. 8034-8039

Keyword(s):

Femoral Neck ◽

Proximal Femur ◽

Adult Population ◽

Femoral Offset ◽

Femoral Neck Axis ◽

Neck Shaft Angle ◽

Shaft Angle ◽

The Mean ◽

Axis Length ◽

Neck Diameter

Background: Hip surgeries such as fracture fixation, corrective osteotomy, hemiarthroplasty, or total hip arthroplasty require accurate preoperative templating for a successful outcome. Such templating is done using the proximal femur and the acetabulum radiographs, depending on the planned surgery. Understanding the normal radiographic anatomy of the proximal femur is crucial to differentiate a normal from pathological anatomy. Proximal femoral anatomic indices include the femoral head diameter, femoral neck diameter, femoral neck length, femoral offset, femoral neck axis length and the femoral neck-shaft angle. Aim: This study assesses and establishes the average values of the proximal femoral anatomy in an indigenous African adult population. Method: This cross-sectional study examined 190 normal anteroposterior (AP) radiographs of the pelvis. The mean age, weight and height of the subjects were obtained. The following proximal femoral anatomic parameters were measured: femoral neck length (FNL), femoral neck diameter (FND), femoral head diameter (FHD), femoral neck-shaft angle (FNSA), femoral offset (FO) and femoral neck axis length (FNAL). The authors compared the mean difference of the parameters between the genders and the age categories and assessed the parameter correlations with the patients’ weight and height. Results: Males constituted 63 (33.2%) of the study population. The mean age of the subjects was 51.46 years (SD = 16.37). The mean weight was 76.13 kg, while the mean height was 1.62 m. The mean values of the proximal femoral parameters were as follows: FNL 4.52cm, FND 3.42cm, FHD 4.76cm, FNSA 132.960, FO 4.09cm, and FNAL 10.34cm. Males have a significantly higher mean value in all the parameters except the FO. None of the parameters showed any significant difference among the age categories except the FNL. A post-hoc analysis showed that the difference in the FNL lies between the young and the elderly age groups. The subjects’ height correlated with all the parameters except FNSA, while the weight correlated with the FND, FNSA and FNAL. Conclusion: The proximal femoral anatomy in Africans differed from those published in foreign literature. This knowledge is crucial for implant manufacturing companies and preoperative templating for hip surgeries. KEY WORDS: Proximal femur, Anatomy, Black population.

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Nano-structural signs of the cortical bone fragility: atomic force microscopy study in the femoral neck of elderly hip fracture patients and healthy aged controls

Bone Abstracts ◽

10.1530/boneabs.1.pp48 ◽

2013 ◽

Author(s):

Petar Milovanovic ◽

Zlatko Rakocevic ◽

Jelena Potocnik ◽

Danijela Djonic ◽

Vladimir Zivkovic ◽

...

Keyword(s):

Atomic Force Microscopy ◽

Hip Fracture ◽

Femoral Neck ◽

Cortical Bone ◽

Microscopy Study ◽

Bone Fragility ◽

Atomic Force Microscopy Study ◽

Force Microscopy ◽

Atomic Force

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HIP FRACTURES IN 5 YEARS AT HUE UNIVERSITY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2013.6.8 ◽

2014 ◽

pp. 47-50

Author(s):

Duy Binh Ho ◽

Nghi Thanh Nhan Le ◽

Maasalu Katre ◽

Koks Sulev ◽

Märtson Aare

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Hip Fractures ◽

Age Groups ◽

Femoral Fractures ◽

Femoral Neck Fractures ◽

University Hospital ◽

High Risk Population ◽

Intertrochanteric Fractures ◽

Significant Difference

Aim: This study aimed to review the clinical findings and surgical intervention of the hip fracture at the Hue University Hospital in Vietnam. Methods:The data of proximal femoral fractures was collected retrospectively. All patients, in a period of 5 years, from Jan 2008 to December 2012, suffered either from intertrochanteric or femoral neck fractures. The numbers of patients were gathered separately for each year, by age groups (under 40, 40-49, 50-59, 60-69, 70-79, older) and by sex. We analyzed what kind of treatment options were used for the hip fracture. Results:Of 224 patients (93 men and 131 women) studied, 71% patients are over 70 years old, 103 women and 56 men (p<0.05). For patients under 40 years, there were 1 woman and 11 men (p<0.05). There were 88 intertrochanteric and 136 femoral neck fractures. There was no significant difference in the two fractures between men and women. The numbers of hip fracture increased by each year, 29/224 cases in 2010, 63/224 cases in 2011, 76/224 cases in 2012. Treatment of 88 intertrochanteric fractures: 49 cases (55.7%) of dynamic hip screw (DHS), 14 cases of hemiarthroplasty (15.9%), 2 cases of total hip replacement (2.3%). Treatment of 136 femoral neck fractures: 48 cases of total replacement (35.3%), 43 cases of hemiarthroplasty (31.6%), 15 cases of screwing (11%). In cases of 40 patients (17.9%) hip fracture was managed conservatively, 23 were femoral neck fractures and 17 were intertrochanteric fractures. Conclusions: Hip fracture is growing challenge in Hue medical university hospital. The conservative approach is still high in people who could not be operable due to severe medical conditions as well as for patients with economic difficulties. Over 70% of the hip fractures in people 70+ are caused by osteoporosis. The number of hip fracture is increasing in the following years, most likely due to the increase in the prevalence of osteoporosis. Early detection and prevention of osteoporosis should be addressed, particularly in high risk population. More aggressive surgical approach should be implemented in order to improve the quality of life in patients with hip fractures. Key words:Hip fracture.

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Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02482-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Inuuteq Fleischer ◽

Mogens Laursen ◽

Stig Andersen

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Fracture Risk ◽

Cortical Thickness ◽

Geometric Analysis ◽

Osteoporotic Fractures ◽

Premature Death ◽

Neck Length ◽

Hip Geometry ◽

Lesser Trochanter

Abstract Background Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. Methods We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. Results We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). Conclusion Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

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Hip fractures among the elderly in Kyoto, Japan: a 10-year study

Archives of Osteoporosis ◽

10.1007/s11657-021-00888-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maki Asada ◽

Motoyuki Horii ◽

Kazuya Ikoma ◽

Tsuyoshi Goto ◽

Naoki Okubo ◽

...

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Incidence Rate ◽

Acute Care ◽

Hip Fractures ◽

Age Groups ◽

The Elderly ◽

Femoral Neck Fractures ◽

Age Group ◽

Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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