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

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 Geometry in Hip Fracture Patients in Greenland

10.21203/rs.3.rs-93175/v1 ◽

2020 ◽

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 that has a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group and data on hip geometry is missing. This let us to describe hip geometry in populations with hip fracture 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 a 7.7-year period. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate.Results: We found collodiaphysial angle of 134.8/132.6o in men/women (p=0.06) and femoral neck length of 38.0/33.9mm in men/women (p=0.001). Cortical thickness was influenced by sex in the adjusted analysis (p<0.001). Cortical thickness index at 5cm below the centre of the lesser trochanter decreased with age (p=0.026) and may be influenced by height (2cm below the centre of the lesser trochanter, p=0.053). Conclusion: Our findings differed from European reference data and suggest a delicate balance in hip geometry that may change with lifestyle transition in Arctic populations. Ethnic peculiarities influence the hip structure and may have an impact on fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

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Femoral Neck Length and Hip Fracture Risk

Journal of Bone and Mineral Research ◽

10.1359/jbmr.1999.14.10.1714 ◽

1999 ◽

Vol 14 (10) ◽

pp. 1714-1720 ◽

Cited By ~ 73

Author(s):

John Michelotti ◽

John Clark

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Fracture Risk ◽

Neck Length ◽

Hip Fracture Risk

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Long-Term Prediction of Incident Hip Fracture Risk in Elderly White Women: Study of Osteoporotic Fractures

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2004.52410.x ◽

2004 ◽

Vol 52 (9) ◽

pp. 1479-1486 ◽

Cited By ~ 175

Author(s):

Brent C. Taylor ◽

Pamela J. Schreiner ◽

Katie L. Stone ◽

Howard A. Fink ◽

Steven R. Cummings ◽

...

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

White Women ◽

Osteoporotic Fractures ◽

Hip Fracture Risk ◽

Term Prediction ◽

Long Term Prediction

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Assessment of hip protectors and corresponding hip fracture risk using stress calculation in the femoral neck

Medical Engineering & Physics ◽

10.1016/j.medengphy.2005.09.001 ◽

2006 ◽

Vol 28 (6) ◽

pp. 550-559 ◽

Cited By ~ 8

Author(s):

A.B. Spierings ◽

S. Derler

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Fracture Risk ◽

Hip Protectors ◽

Hip Fracture Risk ◽

Stress Calculation

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Analysis of hip geometry by clinical CT for the assessment of hip fracture risk in elderly Japanese women

Bone ◽

10.1016/j.bone.2009.08.059 ◽

2010 ◽

Vol 46 (2) ◽

pp. 453-457 ◽

Cited By ~ 50

Author(s):

Masako Ito ◽

Norimitsu Wakao ◽

Tetsuro Hida ◽

Yasumoto Matsui ◽

Yasue Abe ◽

...

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

Japanese Women ◽

Hip Geometry ◽

Hip Fracture Risk ◽

Elderly Japanese Women ◽

Elderly Japanese

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Are Women with Thicker Cortices in the Femoral Shaft at Higher Risk of Subtrochanteric/Diaphyseal Fractures? The Study of Osteoporotic Fractures

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2011-3256 ◽

2012 ◽

Vol 97 (7) ◽

pp. 2414-2422 ◽

Cited By ~ 17

Author(s):

Nicola Napoli ◽

Jenny Jin ◽

Katherine Peters ◽

Rosanna Wustrack ◽

Shane Burch ◽

...

Keyword(s):

Femoral Neck ◽

Cortical Thickness ◽

Proportional Hazards ◽

Osteoporotic Fractures ◽

Femoral Shaft ◽

Low Energy ◽

Intertrochanteric Fractures ◽

Cortical Thickening ◽

Proportional Hazards Models ◽

Femur Fractures

Abstract Context: Femoral shaft cortical thickening has been mentioned in reports of atypical subtrochanteric and diaphyseal (S/D) femur fractures, but it is unclear whether thickening precedes fracture or results from a preceding stress fracture and what role bisphosphonates might play in cortical thickening. Objective: Our objective was to examine the relationship of cortical thickness to S/D fracture risk as well as establish normal reference values for femoral cortical thickness in a large population-based cohort of older women. Design: Using pelvic radiographs obtained in 1986–1988, we measured femoral shaft cortical thickness 3 cm below the lesser trochanter in women in the Study of Osteoporotic Fractures. We measured this in a random sample and in those with S/D fractures and femoral neck and intertrochanteric fractures. Low-energy S/D fractures were identified from review of radiographic reports obtained between 1986 and 2010. Radiographs to evaluate atypia were not available. Analysis used case-cohort, proportional hazards models. Outcomes: Cortical thickness as a risk factor for low-energy S/D femur fractures as well as femoral neck and intertrochanteric fractures in the Study of Osteoporotic Fractures, adjusting for age and bone mineral density in proportional hazards models. Results: After age adjustment, women with thinner medial cortices were at a higher risk of S/D femur fracture, with a relative hazard of 3.94 (95% confidence interval = 1.23–12.6) in the lowest vs. highest quartile. Similar hazard ratios were seen for femoral neck and intertrochanteric fractures. Medial or total cortical thickness was more strongly related to fracture risk than lateral cortical thickness. Conclusions: In primarily bisphosphonate-naive women, we found no evidence that thick femoral cortices placed women at higher risk for low-energy S/D femur fractures; in fact, the opposite was true. Women with thin cortices were also at a higher risk for femoral neck and intertrochanteric fractures. Whether cortical thickness among bisphosphonate users plays a role in atypical S/D fractures remains to be determined.

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Femoral neck cortical thickness and intracapsular hip fracture: A re-appraisal

Bone ◽

10.1016/j.bone.2010.04.428 ◽

2010 ◽

Vol 47 ◽

pp. S182 ◽

Cited By ~ 1

Author(s):

N. Loveridge ◽

J. Power ◽

H. Kroger ◽

M. Parker ◽

N. Rushton ◽

...

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Cortical Thickness ◽

Intracapsular Hip Fracture

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Comparison of osteoporotic fracture risk in surgical and natural menopausal patients

Turkish Journal of Physical Medicine and Rehabilitation ◽

10.5606/tftrd.2021.5918 ◽

2021 ◽

Vol 67 (3) ◽

pp. 322-327

Author(s):

Ayça Utkan Karasu ◽

Yetkin Karasu ◽

Müzeyyen Gülnur Özakşit ◽

Yusuf Üstün ◽

Yaprak Üstün Engin

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Fracture Risk ◽

Osteoporotic Fracture ◽

Assessment Tool ◽

Lumbar Vertebrae ◽

Mineral Density ◽

Natural Menopause ◽

T Score ◽

Surgical Menopause

Objectives: This study aims to compare the fracture risk calculated with Fracture Risk Assessment Tool (FRAX®) in patients with natural and surgical menopause. Patients and methods: Between April 2019 and July 2019, 285 postmenopausal patients (mean age 57.3 years; range, 40 to 78 years) who were admitted to the menopause clinic were enrolled in this prospective cross-sectional study. Of these, 220 were in natural menopause and 65 were in surgical menopause. Demographic data, medical history, and International Physical Activity Questionnaire scores were collected through face-to-face interviews with the patients. Femoral neck and lumbar vertebrae (L1-L4) T-scores were evaluated using dual-energy X-ray absorptiometry. Fragility fracture risk was assessed using FRAX®. Results: The groups were similar in terms of age, body mass index, duration of menopause, smoking, alcohol use, and history of fracture (p>0.05). The risk of major osteoporotic fracture and hip fracture calculated without adding bone mineral density (BMD) was similar between groups (p=0.417 and p=0.234). The risk of hip fracture calculated with the addition of BMD was higher in natural menopause patients (p=0.023). Lumbar vertebrae T-scores were similar between two groups regardless of age; femoral neck T-scores were higher in surgical menopause (T-score=-0.8) than natural menopause group (T-score=-1.25) aged under 60 years, whereas this difference disappeared after 60 years of age. Conclusion: In our study, the fracture risk and the severity of osteoporosis were not different in surgical menopausal patients compared to the natural menopausal patients. Hip fracture risk calculated using BMD was lower in patients under 50 years of age in surgical menopausal patients. However, the fracture risks were similar in both groups after 50 years of age.

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