Cortical bone structure of the proximal femur and incident fractures

Nissen, Frida Igland; Andreasen, Camilla; Borgen, Tove Tveitan; Bjørnerem, Åshild; Hansen, Ann Kristin

doi:10.1016/j.bone.2021.116284

Cited by 6 publications

(13 citation statements)

References 29 publications

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“…The combination of selected geometry variables in this study resulted in a similar AUC value (0.805) as the use of aBMD alone (AUC 0.796 or 0.804) reported previously in case-control studies (11,24). Further, the AUC values of the combination of selected geometry variables in this study were similar to those reported for reference aBMD in prospective studies, ranging from 0.70 to 0.86 (32)(33)(34)(35)(36)(37)(38). Although AUC and OR results varied amongst these studies of different datasets, evidence is accumulating for a slight improvement in hip fracture risk assessment.…”

Section: Discussionsupporting

confidence: 85%

Differences in Hip Geometry Between Female Subjects With and Without Acute Hip Fracture: A Cross-Sectional Case-Control Study

Yang¹,

Liu²,

Ge³

et al. 2022

Front. Endocrinol.

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Background and PurposeAlthough it is widely recognized that hip BMD is reduced in patients with hip fracture, the differences in geometrical parameters such as cortical volume and thickness between subjects with and without hip fracture are less well known.Materials and MethodsFive hundred and sixty two community-dwelling elderly women with hip CT scans were included in this cross-sectional study, of whom 236 had an acute hip fracture. 326 age matched women without hip fracture served as controls. MIAF-Femur software was used for the measurement of the intact contralateral femur in patients with hip fracture and the left femur of the controls. Integral and cortical volumes (Vols) of the total hip (TH), femoral head (FH), femoral neck (FN), trochanter (TR) and intertrochanter (IT) were analyzed. In the FH and FN the volumes were further subdivided into superior anterior (SA) and posterior (SP) as well as inferior anterior (IA) and posterior (IP) quadrants. Cortical thickness (CortThick) was determined for all sub volumes of interest (VOIs) listed above.ResultsThe average age of the control and fracture groups was 71.7 and 72.0 years, respectively. The fracture patients had significantly lower CortThick and Vol of all VOIs except for TRVol. In the fracture patients, cortical thickness and volume at the FN were significantly lower in all quadrants except for cortical volume of quadrant SA (p= 0.635). Hip fracture patients had smaller integral FN volume and cross-sectional area (CSA) before and after adjustment of age, height and weight. With respect to hip fracture discrimination, cortical volume performed poorer than cortical thickness across the whole proximal femur. The ratio of Cort/TrabMass (RCTM), a measure of the internal distribution of bone, performed better than cortical thickness in discriminating hip fracture risk. The highest area under curve (AUC) value of 0.805 was obtained for the model that included THCortThick, FHVol, THRCTM and FNCSA.ConclusionThere were substantial differences in total and cortical volume as well as cortical thickness between fractured and unfractured women across the proximal femur. A combination of geometric variables resulted in similar discrimination power for hip fracture risk as aBMD.

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Section: Discussionsupporting

confidence: 85%

Differences in Hip Geometry Between Female Subjects With and Without Acute Hip Fracture: A Cross-Sectional Case-Control Study

Yang¹,

Liu²,

Ge³

et al. 2022

Front. Endocrinol.

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“…A large number of papers have been published in the world literature which try to find the factors that influence the prognosis of hip fractures, both in the physical recovery of the patient and in their survival [1,3,7,9]. Knowing the predictors of mortality is very useful because of the treatment plan for each patient individually, and in that way, the risk of death would be reduced [4,6,8].…”

Section: Discussionmentioning

confidence: 99%

“…Factors affecting mortality after hip fracture are: age, gender, poor mobility of the patient before fracture, poor mental status, dementia or cognitive impairment, diabetes, heart disease, cancer, comorbidities, higher ASA score, type of fracture, operative delay [5,10]. The mortality rate during hospital stay (intrahospital mortality) for patients with hip fracture in persons older than 70 years is between 2-20% [7,10,11]. It usually ranges from 5-7%, although in some studies it is significantly higher and is most often associated with the effects of acute trauma on the patient, length of hospital stay in the postoperative period, worsening of existing comorbidities, and possible surgical postoperative complications [4,5,11].…”

Section: Discussionmentioning

confidence: 99%

“…Age in patients with hip fractures is one of the main predictors of mortality. People with hip fractures older than 85 have an absolutely high mortality rate [4,7,11]. The mortality rate increases exponentially with age, while in persons under 75 it is about 7% per year, in persons over 85 it is about 33% in the first postoperative year [7,16].…”

Section: Discussionmentioning

confidence: 99%

“…The method of choice for patients with hip fractures is surgical treatment. In intra-articular fractures, hemiarthroplasty or total arthroplasty is used, and in extracapsular fractures, open repositioning and internal fixation of fractures are used [3,4,7]. Non-operative treatment is applied only in patients in whom the general condition is so bad that the risk of surgery is greater than the advantage of early fixation.…”

Section: Introductionmentioning

confidence: 99%

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Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Petrović¹,

Dimić²,

Bozovic³

et al. 2022

Srp Arh Celok Lek

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Introduction/Objective. Epidemiological research shows that we have a dramatic increase in the number of people with hip fractures, especially those over 65 years of age. The objectives of this study are to assess the association between preoperative comorbidity and the risk of postoperative complications and mortality and postoperative worsening of comorbid conditions and their relationship to mortality within one year of hip fracture surgery. Methods. In this retrospective study, from January 2018 until January 2020, 64 patients with hip fractures were operated on at the Department of Orthopedic Surgery in Kosovska Mitrovica. We monitored the number of comorbidities and their significance on the preoperative risk and the course of concomitant diseases in the postoperative period and one-year mortality after surgery, in patients with hip fractures. Results. We collected data on patients from the moment of admission to discharge from the hospital accompanied by medical histories, and after discharge after follow-up examinations, six months and one year from discharge. Of the total number of subjects, 23 (35.9%) had one or two comorbidities, most often of cardiac and neurological nature, in 25 patients (39.1%) we had three concomitant diseases, and in 11 (17.2%) four and more comorbidities. The mean age of the patients was 72.51 years (69?92 years). Conclusion. Approximately 45?60% of men and women who suffer a hip fracture have three or more comorbid states. In older people with hip fractures, the presence of three or more comorbidities is the strongest preoperative risk factor.

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Prediction of the critical energy release rate for rat femoral cortical bone structure under different failure conditions

Fan,

Yang,

Liu

et al. 2023

Computer Methods and Programs in Biomedicine

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Cortical bone structure of the proximal femur and incident fractures

Cited by 6 publications

References 29 publications

Differences in Hip Geometry Between Female Subjects With and Without Acute Hip Fracture: A Cross-Sectional Case-Control Study

Differences in Hip Geometry Between Female Subjects With and Without Acute Hip Fracture: A Cross-Sectional Case-Control Study

Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Prediction of the critical energy release rate for rat femoral cortical bone structure under different failure conditions

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