scholarly journals Femoral Neck Shaft Angle in Men with Fragility Fractures

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
S. P. Tuck ◽  
D. J. Rawlings ◽  
A. C. Scane ◽  
I. Pande ◽  
G. D. Summers ◽  
...  

Introduction. Femoral neck shaft angle (NSA) has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men.Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric), symptomatic vertebral (91), and distal forearm (67) fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm2: lumbar spine, femoral neck, and total femur) measurements were performed.Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately), nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2°versus 131°:P=0.001), but larger in those with distal forearm fractures (129.8°versus 128.5°:P=0.01).Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10683
Author(s):  
Jun Chen ◽  
Lingchun Lyu ◽  
Jiayi Shen ◽  
Chunlai Zeng ◽  
Cheng Chen ◽  
...  

Objective Our study aimed to assess the risk of all fractures and hip fractures in patients with atrial fibrillation (AF) who took non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. Methods We searched PubMed, Embase, and Cochrane Library and Clinical Trials.gov Website. Reviewed related researches up to January 31, 2020, to identify studies with more than 12 months of follow-up data. The protocol for this systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO Number: CRD42020156893). Results We included five RCT studies, and five observational studies that contained a total of 326,846 patients in our meta-analysis. Our meta-analysis showed that patients taken NOACs had no significant all fracture risk (RR = 0.91, 95% CI [0.81–1.01]) and hip fracture risk (RR = 0.92, 95% CI [0.82–1.03]) compared with those taken warfarin. Subanalysis showed that the risk of all fractures and hip fractures treated by NOACs were significant lower compared with warfarin in observational studies compared with RCT studies. Also, a subanalysis across the duration of anticoagulation showed the NOACs users have lower all fracture risk than warfarin users when the duration of anticoagulation ≤2 years (RR = 0.89, 95% CI [0.80–0.99]). Further analysis, significant lower all fracture risk in the rivaroxaban therapy (RR = 0.81; 95% CI [0.76–0.86]) compared with warfarin but no statistical significance in hip fracture. There were no significant difference of all fracture risk and hip fracture risk in dabigatran, apixaban, and edoxaban therapy compared with warfarin. Conclusion The meta-analysis demonstrated that NOACs associated with a significantly lower all fracture risk compared with warfarin when the duration of anticoagulation more than 2 years. Rivaroxaban users had lower risk of all fracture than warfarin users in AF patients. But there was no evidence to verify apixaban, edoxaban, and dabigatranin could decrease all fracture and hip fracture risk compared with warfarin.


Author(s):  
Bernard O. Obande ◽  
Emmanuel C. Iyidobi ◽  
Gabriel O. Eyichukwu ◽  
Cajetan U. Nwadinigwe ◽  
Remigus T. Ekwunife ◽  
...  

<p class="abstract"><strong>Background:</strong> The femoral neck-shaft angle (FNSA) has been implicated in the aetiology of hip fractures. The longer moment arm of a higher FNSA has been theorized to impart a greater deforming force to the greater trochanter, which may cause a hip fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective study that involves adults with hip fractures and a control group matched for age and sex. The FNSA of both groups were measured on an anteroposterior X-ray of the pelvis. The mean FNSA were compared with a paired samples t-test, and a binary logistic regression analysis was run with the FNSA as a predictor variable and the presence of hip fracture as an outcome variable.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 150 patients were recruited for the study, 75 per group. The mean age of patients with hip fractures was 71.30 years (S.D.=14.34), and that of the control group was 73.94 years (S.D.=12.55), p=0.264. The mean FNSA of the study group was 133.96<sup>o</sup> (S.D.=3.77) while that of the control group was 131.05<sup>o</sup> (S.D.=3.86), p&lt;0.001. Increasing FNSA imparts a higher risk of having a hip fracture, O.R.=1.24 (95% C.I, 1.12-1.37).</p><p><strong>Conclusions:</strong> Individuals with higher FNSA demonstrated a significantly increased risk of developing hip fractures. However, the exact cut-off point of the FNSA, which predisposes to the risk of these fractures, remains to be elucidated. </p>


2014 ◽  
pp. 47-50
Author(s):  
Duy Binh Ho ◽  
Nghi Thanh Nhan Le ◽  
Maasalu Katre ◽  
Koks Sulev ◽  
Märtson Aare

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.


2018 ◽  
Vol 159 (38) ◽  
pp. 1543-1547
Author(s):  
Krisztina Juhász ◽  
Imre Boncz ◽  
Péter Kanizsai ◽  
Andor Sebestyén

Abstract: Introduction: Although several national studies reported on the risk factors for contralateral hip fracture, there are no data about the prognostic factors of the time until contralateral hip fractures. Aim: The aim of the study was to analyse the impact of different prognostic factors on the time until the development of contralateral fracture and to determine the incidence of contralateral hip fractures after femoral neck fractures. Method: Patients aged 60 years and over with contralateral hip fracture between 01 Jan 2000 and 31 Dec 2008 were identified among those who suffered their femoral neck fracture in Hungary in 2000. Risk factors as age, sex, comorbidities, type of fracture and surgery, place of living and hospitals providing treatment for primary fracture were analysed by one way ANOVA focusing on the time until the development of contralateral hip fracture. Results: 312 patients met the inclusion criteria. The incidence of contralateral hip fracture after femoral neck fracture ranged between 1.5% and 2.1%, the cumulative incidence was 8.24%. The mean time until the development of contralateral hip fracture was 1159.8 days. The incidence of contralateral hip fracture showed no significant deviation. Significantly shorter time (p = 0.010) was detected until the contralateral hip fracture in older patients with femoral neck fracture. Conclusions: The yearly incidence of contralateral hip fracture showed no significant difference by patients with femoral neck fracture over 60 years. The shorter time until the contralateral hip fracture by the older age groups highlights the need of elaboration of prevention strategies. Orv Hetil. 2018; 159(38): 1543–1547.


The Lancet ◽  
2005 ◽  
Vol 366 (9496) ◽  
pp. 1524-1525
Author(s):  
Jonathan Reeve ◽  
Paul M Mayhew ◽  
C David Thomas ◽  
Nigel Loveridge ◽  
Chris J Burgoyne

The Lancet ◽  
2005 ◽  
Vol 366 (9496) ◽  
pp. 1523-1524 ◽  
Author(s):  
Mary L Bouxsein ◽  
Roberto J Fajardo

2021 ◽  
Author(s):  
Zhe Li ◽  
Jiayu Yang ◽  
Xinghua Li ◽  
Kunzheng Wang ◽  
Jungang Han ◽  
...  

Abstract Bacnground: Accurate measurement of the femoral neck-shaft angle (NSA) is of great significance for diagnosing hip joint diseases and preoperative planning of total hip arthroplasty. However, the fitting lines of the femoral neck and femoral shaft did not always intersect in 3D space. Thus, it is unclear whether there is a difference between 2D and 3D methods for measuring NSA. Methods: The femoral point cloud datasets from 310 subjects were segmented into three regions, including the femoral head, femoral neck, and femoral shaft using PointNet++. We created a projection plane to simulate the hip anteroposterior radiograph and fitted the femoral neck axis and femoral shaft axis to complete the 2D measurement, while we directly fitted the two axes in space to complete the 3D measurement. Also, we conducted the manual measurement of the NSA. We verified the accuracy of the segmentation and compared the results of the two automatic and manual methods. Results: The Dice coefficient of femoral segmentation reached 0.9746, and MIoU of that was 0.9165. No significant difference was found between any two of the three methods. While comparing the 2D and 3D methods, the average accuracy was 98.00%, and the average error was 2.58°. Conclusion: This paper proposed two accurate and automatic methods to measure the NSA based on a 2D plane and a 3D model respectively. Although the femoral neck and femoral shaft axes did not intersect in 3D space, the NSAs obtained by 2D and 3D methods were basically consistent.


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