Radiographic anatomy of the proximal femur: femoral neck fracture vs. transtrochanteric fracture

Lima, Ana Lecia Carneiro Leão de Araújo; Miranda, Saul Caldas; Vasconcelos, Hudson Felipe Oliveira de

doi:10.1016/j.rboe.2017.10.007

Cited by 4 publications

(9 citation statements)

References 28 publications

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“…The WIR has been positively associated with intertrochanteric fractures. 15 As in the present study, according to Lima et al 21 no statistically significant differences between neck and intertrochanteric fractures regarding ATD were observed. The contradictory results found in the current literature may be attributed to sampling and analysis techniques.…”

Section: Discussionsupporting

confidence: 55%

“…14 As in the present study, according to Lima et al no statistically significant differences between neck and intertrochanteric fractures regarding ATD were observed. 19 The contradictory results found in the current literature may be attributed to sampling and analysis techniques. Namely small cohorts, the application of unrestricted exclusion criteria and a limited variety of analyzed PFG measurements -factors that we have tried to correct in our study.…”

Section: Discussionmentioning

confidence: 93%

“…18 A positive association between the variability of the proximal femur geometry and prediction of fracture risk has been demonstrated. 19 Gluer et al enhanced the importance of PFG by concluding that a simple analysis of hip geometry based on pelvic radiographs can be a predictor of PFF risk as strong as hip bone density. 14 This study aims to establish the contribution of proximal femur geometry in the occurrence of intertrochanteric, neck and subtrochanteric fractures.…”

Section: Discussionmentioning

confidence: 99%

“…20 A positive association between the variability of the proximal femur geometry and prediction of fracture risk has been demonstrated. 21 Glüer et al 15 enhanced the importance of PFG by concluding that a simple analysis of hip geometry based on pelvic radiographs can be a predictor of PFF risk as strong as hip bone density.…”

Section: Discussionmentioning

confidence: 99%

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Proximal femur geometry: a major predictor of proximal femur fracture subtypes

Senra

Carvalho

Silva³

et al. 2022

HIP International

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Introduction: Proximal femur geometry (PFG) represents an important risk factor for the occurrence of hip fractures. There are currently few studies regarding the correlation between PFG and the occurrence of a specific fracture subtype, and those that exist have small cohorts and present with different methodologies and contradictory results. Therefore, there is no consensus in the literature regarding this topic. The present study aimed to establish the contribution of the PFG in the occurrence of different subtypes of proximal femur fractures (PFF): intertrochanteric, neck and subtrochanteric. Methods: Analysis of 1022 plain anteroposterior pelvic radiographs of patients consecutively admitted to the emergency room of a Level 1 Trauma Centre between 2013 and 2019 after low energy trauma who presented with PFF and underwent surgical treatment. Patients were analysed considering age, gender and subtype of PFF (intertrochanteric, neck or subtrochanteric). Radiological parameters including cervicodiaphyseal angle (CDA), horizontal offset (HO), femoral neck width (FNW), femoral neck length (FNL), great trochanter-pubic symphysis distance (GTPSD), acetabular teardrop distance (ATD) and width of the intertrochanteric region (WIR) were measured and compared between the different subtypes of fractures (7154 measurements). Statistical analysis was conducted recurring to absolute measurements and measurements ratios. The correlation was assessed using t-test. Results: There were statistically significant differences in proximal femur geometry between the different subtypes of fractures. Patients presenting with femoral neck fractures had greater CDA (132.5 ± 6.9 vs. 130.0 ± 7.3; p < 0.001) and lower HO (45.8 ± 7.4 vs. 49.0 ± 8.0; p < 0.001), HO/ATD (0.34 ± 0.068 vs. 0.37 ± 0.072; p < 0.001) and HO/GTPSD (0.26 ± 0.049 vs. 0.28 ± 0.039; p < 0.001) than patients with intertrochanteric/subtrochanteric fractures. Conclusions: PFG represents an important contributor to the occurrence of different fracture subtypes. Femoral neck fractures are associated with greater CDA and lower HO, HO/ATD and HO/GTPSD when compared to intertrochanteric or subtrochanteric fractures.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Proximal femur geometry: a major predictor of proximal femur fracture subtypes

Senra

Carvalho

Silva³

et al. 2022

HIP International

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“…Any patients with history of surgery in the ipsilateral hip or contralateral hip, polytrauma, unstable Intertrochanteric fracture or OA of hip joint were excluded from the study. The restoration of normal anatomy was assessed on the post-operative Pelvis with both hips plain radiograph (Buecking et al, 2015;Lima et al, 2017). The restoration of normal anatomy was assessed by the experienced orthopaedic surgeon who had not operated any of the recruited patients.…”

Section: Methodsmentioning

confidence: 99%

Comparison of post-operative hip abductor muscle strength and functional outcome between dynamic hip screw and proximal femoral nail in intertrochanteric fracture

Patel¹,

Golwala²

2023

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Extra capsular intertrochanteric femur fractures occur between femoral neck and lesser trochanter of the femur. However, this study aims to study the influence of restoration of femoral offset in relation to the strength of the hip abductor muscle along with the functional outcomes. In patients with ≥18 years of age that were operated for Intertrochanteric fracture and referred for physiotherapy, a prospective cohort study was performed. On the principles of deep venous thrombosis (DVT) prevention, strengthening exercises, ROM exercises and gait training the patients were given physiotherapy. Once weight bearing was allowed on 6 weeks, their gait parameters (stride length, cadence), functional strength (Unilateral stance test) and Harris Hip Score were measured. The same outcome measures along with the strength of hip abductor muscle were repeated at 6 months as femoral offset is important for restoring anatomy. In conclusion, weak hip abductor muscle strength was exhibited in patients with unrestored femoral offset and better outcomes were reported in patients with Dynamic Hip Screw fixation in comparison to other surgeries in young population. Additionally, the functional status of the patients with more than 70 years of age remained poor in comparison to the younger patients post-operatively.

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