Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 7/2016

01-09-2016 | Original Article

Comparison of morphological features in the femur between femoral neck fractures and femoral intertrochanteric fractures

Authors: Koun Yamauchi, Mitsuishi Naofumi, Hisashi Sumida, Shoji Fukuta, Hirohiko Hori

Published in: Surgical and Radiologic Anatomy | Issue 7/2016

Login to get access

Abstract

Purpose

The purpose of this study is to make proximal femur fracture types more predictable by considering morphological features of an acetabulum as well as of a proximal femur in the Japanese population.

Methods

A retrospective review of radiographs of the proximal femoral fractures was conducted in patients registered from 2010 to 2012, dividing into patients with femoral neck fractures; Group Neck (n = 101), and patients with femoral intertrochanteric fractures; Group IT (n = 99). Intergroup comparison was conducted: age, sex, height, weight, the ratios of femoral intertrochanteric length (IT Length), femoral neck length (Neck Length), femoral neck width (Neck Width), lateral offset length (Offset) to femoral head diameter, neck–shaft angle (N–S angle), and center–edge angle of the acetabulum (C–E angle), adjusting for age. Multiple logistic regression analysis was conducted among these parameters.

Results

The Group IT showed significantly older age than the Group Neck. Greater C–E angle in Group IT was observed in the patients in their 80s and 90s years of age. The Group Neck showed greater N–S angle only in the patients in their 80s years of age. In multiple logistic regression analysis, the impact of the age and the C–E angle on the fracture types was similar (odds ratio 1.08, 1.09, respectively, p < 0.01 both).

Conclusions

Age, N–S angle, and C–E angle could be independent predictors for determining the proximal femur fracture types.
Literature
1.
go back to reference Duboeuf F, Hans D, Schott AM, Kotzki PO, Favier F, Marcelliet C (1997) Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: the EPIDOS Study. J Bone Miner Res 12:1895–1902CrossRefPubMed Duboeuf F, Hans D, Schott AM, Kotzki PO, Favier F, Marcelliet C (1997) Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: the EPIDOS Study. J Bone Miner Res 12:1895–1902CrossRefPubMed
2.
go back to reference Ferris BD, Kennedy C, Bhamra M, Muirhead-Allwood W (1989) Morphology of the femur in proximal femoral fractures. J Bone Joint Surg Br 71:475–477PubMed Ferris BD, Kennedy C, Bhamra M, Muirhead-Allwood W (1989) Morphology of the femur in proximal femoral fractures. J Bone Joint Surg Br 71:475–477PubMed
3.
go back to reference Gluer CC, Cummings SR, Pressman A, Li J, Gluer K, Faulkner KG, Grampp S (1994) Prediction of hip fractures from pelvic radiographs: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 9:671–677CrossRefPubMed Gluer CC, Cummings SR, Pressman A, Li J, Gluer K, Faulkner KG, Grampp S (1994) Prediction of hip fractures from pelvic radiographs: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 9:671–677CrossRefPubMed
4.
go back to reference Gnudi S, Ripamonti C, Lisi L, Fini M, Giardino R, Giavaresi G (2002) Proximal femur geometry to detect and distinguish femoral neck fractures from trochanteric fractures in postmenopausal women. Osteoporos Int 13:69–73CrossRefPubMed Gnudi S, Ripamonti C, Lisi L, Fini M, Giardino R, Giavaresi G (2002) Proximal femur geometry to detect and distinguish femoral neck fractures from trochanteric fractures in postmenopausal women. Osteoporos Int 13:69–73CrossRefPubMed
5.
go back to reference Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9:1889–1894CrossRefPubMed Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9:1889–1894CrossRefPubMed
6.
go back to reference Greenspan SL, Myers ER, Kiel DP, Parker RA, Hayes WC, Resnick NM (1998) Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med 104:539–545CrossRefPubMed Greenspan SL, Myers ER, Kiel DP, Parker RA, Hayes WC, Resnick NM (1998) Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med 104:539–545CrossRefPubMed
7.
go back to reference Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA (1993) Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 52:192–198CrossRefPubMed Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA (1993) Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 52:192–198CrossRefPubMed
8.
go back to reference Kok LM, van der Steenhoven TJ, Nelissen RG (2011) A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures. Int Orthop 35:1545–1551CrossRefPubMed Kok LM, van der Steenhoven TJ, Nelissen RG (2011) A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures. Int Orthop 35:1545–1551CrossRefPubMed
9.
go back to reference Mautalen CA, Vega EM, Einhorn TA (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone 18:133–137CrossRef Mautalen CA, Vega EM, Einhorn TA (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone 18:133–137CrossRef
10.
go back to reference Pande I, O’Neill TW, Pritchard C, Scott DL, Woolf AD (2000) Bone mineral density, hip axis length and risk of hip fracture in men: results from the Cornwall Hip Fracture Study. Osteoporos Int 11:866–870CrossRefPubMed Pande I, O’Neill TW, Pritchard C, Scott DL, Woolf AD (2000) Bone mineral density, hip axis length and risk of hip fracture in men: results from the Cornwall Hip Fracture Study. Osteoporos Int 11:866–870CrossRefPubMed
11.
go back to reference Partanen J, Jamsa T, Jalovaara P (2001) Influence of the upper femur and pelvic geometry on the risk and type of hip fractures. J Bone Miner Res 16:1540–1546CrossRefPubMed Partanen J, Jamsa T, Jalovaara P (2001) Influence of the upper femur and pelvic geometry on the risk and type of hip fractures. J Bone Miner Res 16:1540–1546CrossRefPubMed
12.
go back to reference Pulkkinen P, Partanen J, Jalovaara P, Jamsa T (2004) Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int 15:274–280CrossRefPubMed Pulkkinen P, Partanen J, Jalovaara P, Jamsa T (2004) Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int 15:274–280CrossRefPubMed
13.
go back to reference Rafferty KL (1997) Structural design of the femoral neck in primates. J Hum Evol 34:361–383CrossRef Rafferty KL (1997) Structural design of the femoral neck in primates. J Hum Evol 34:361–383CrossRef
14.
go back to reference Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113:366–374CrossRefPubMed Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113:366–374CrossRefPubMed
15.
go back to reference Sawalha S, Parker MJ (2012) Characteristics and outcome in patients sustaining a second contralateral fracture of the hip. J Bone Joint Surg Br 94:102–106CrossRefPubMed Sawalha S, Parker MJ (2012) Characteristics and outcome in patients sustaining a second contralateral fracture of the hip. J Bone Joint Surg Br 94:102–106CrossRefPubMed
16.
go back to reference Stewart A, Porter RW, Primrose WR, Walker LG, Reid DM (1999) Cervical and trochanteric hip fractures: bone mass and other parameters. Clin Rheumatol 18:201–206CrossRefPubMed Stewart A, Porter RW, Primrose WR, Walker LG, Reid DM (1999) Cervical and trochanteric hip fractures: bone mass and other parameters. Clin Rheumatol 18:201–206CrossRefPubMed
17.
go back to reference Szulc P, Duboeuf F, Schott AM, Dargent-Molina P, Meunier PJ, Delmas PD (2006) Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int 17:231–236CrossRefPubMed Szulc P, Duboeuf F, Schott AM, Dargent-Molina P, Meunier PJ, Delmas PD (2006) Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int 17:231–236CrossRefPubMed
Metadata
Title
Comparison of morphological features in the femur between femoral neck fractures and femoral intertrochanteric fractures
Authors
Koun Yamauchi
Mitsuishi Naofumi
Hisashi Sumida
Shoji Fukuta
Hirohiko Hori
Publication date
01-09-2016
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2016
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-016-1626-9

Other articles of this Issue 7/2016

Surgical and Radiologic Anatomy 7/2016 Go to the issue