Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population

Abstract

Background:Few studies have investigated the differences in proximal femoral geometry and risk factors between patients with different types of hip fracture, especially in elderly Chinese. This study aimed to assess the differences in proximal femoral geometry parameters between patients with femoral neck fractures and patients with intertrochanteric fractures to provide guidance for individualized customized prosthesis and accurate reconstruction of proximal femurs in elderly Chinese patients.Methods:We retrospectively studied the electronic medical records of 198 elderly patients over 65 years of age who were admitted to the orthopedic department with hip fractures between January 2017 and December 2017 in The Third Hospital, Hebei Medical University. Age, fracture site, gender, and proximal femoral geometry parameters (neck shaft angle [NSA], center edge angle [CEA], femoral head diameter [FHD], femoral neck diameter [FND], femoral neck axial length [FNAL], hip axial length [HAL], and femoral shaft diameter [FSD]) were recorded. Student's t-test was used to compare the continuous variables, Chi-square test was used to analyze categorical variables, and multiple logistic stepwise regression analysis was used to evaluate the influencing factors of hip fracture type.Results:Statistically significant differences in NSA (137.63 ± 4.56° vs. 132.07 ± 4.17°, t = 1.598, P < 0.001), CEA (37.62 ± 6.77° vs. 43.11 ± 7.09°, t = 5.597, P < 0.001), FND (35.21 ± 3.25 mm vs. 34.09 ± 3.82 mm, t = 2.233, P = 0.027), and FNAL (99.30 ± 7.91 mm vs. 103.58 ± 8.39 mm, t = 3.715, P < 0.001) were found between the femoral neck fracture group and femoral intertrochanteric fracture group. FHD, FND, FSD, HAL, and FNAL were different between sexes (all P < 0.001). The greater NSA was the risk factor for femoral neck fractures (odds ratio [OR]: 0.70, P < 0.001), greater CEA and longer FNAL were risk factors for femoral intertrochanteric fractures (OR: 1.15, 1.17, all P < 0.001), and greater FND was a protective factor for femoral intertrochanteric fractures (OR: 0.74, P < 0.001).Conclusions:We demonstrate differences in geometric morphological parameters of the proximal femur in different hip fracture types, as well as an effect of sex. These differences should be considered in the selection of prostheses for fracture internal fixation and hip replacements. These data could help guide the design of individualized customized prostheses and improve the accurate reconstruction of the proximal femur for elderly Chinese hip fracture patients.

Does Proximal Hip Geometry Affect Fracture Type in The Elderly Population?

“…In our study, the mean HAL of 33 patients with FNFs was 123.5 ± 14.9 mm, and the HAL of 81 patients with ITFs was 119.3 ± 12.3 mm, but there were no statistically signi cant differences. We found that the hip axis was longer in the FNF group than in the ITF group, which contrasts the results from the study by Hu et al [4].…”

Diagnostic Value of Magnetic Resonance (MR) Combined with Computed Tomography (CT) in Patients with Stress Injury of Femoral Neck

“…However, it is proposed in the study of Sun et al [ 14 ] that CT diagnosis conducted for patients with femoral neck stress injury in the early stage can solve image overlap, display fine details more clearly, and focus on the density of medullary cavity change, but it is still far from being ideal for the ligament injury due to trauma, and scans may be affected by partial volume effect, restricted by soft tissue resolution, misdiagnosis, and diagnosis. In view of this, it is proposed in the study of Hu et al [ 15 ] that the combination of CT and MR can be applied for patients with femoral neck stress injury in the early differential diagnosis. The multisequence and multilayer scanning of the femoral neck position by MR will find the limited hemorrhage of bone marrow cavity, fracture line, and periosteum reaction timely, show the local callus formation or cortical thickening reaction clearly, and improve the diagnostic accuracy by combining CT and clinical signs.…”

Short-Term Application of Chitosan Coated Mg-1Zn-0.3Zr-2Gd-1Ca Alloy Bone Implants in Osteoporotic Fractures

“…Internal fixation is one of the most important surgical treatments for osteoporotic fracture. There are many kinds of internal fixation materials, including Mg-Ca alloys, Zn alloy, and Ti alloys [29]. Among them, the current most clinically applied alloy is the Mg-Ca alloy.…”