Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck

Frost, Andrew; Pavlou, George; Richards, Paula J.; Belcher, John; Jasani, Vinay

doi:10.1007/s11999-009-1185-z

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…The authors stated that the results obtained from the study suggested that patients with femoral neck stress fractures had more common Pincer type impingement findings than the normal population. Contrary to these studies, Frost et al 20 emphasized that although they thought that acetabular retroversion may be a risk factor for intracapsular hip fractures, they did not find any correlation between the fracture type and acetabular version in their study. In our study, we found a significant difference in the acetabular version between the unaffected contralateral hip and the hip which underwent open reduction and internal fixation due to a femoral neck fracture which may suggest that acetabular retroversion increases the risk of femoral neck fractures.…”

Section: Discussionmentioning

confidence: 64%

The Association Between Femoroacetabular Impingement and Internal Fixation of Femoral Neck Fractures

Kılıç¹,

Özmanevra²,

Eroğlu³

2021

HIP

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Objective: Congenital deformities, slipped capital femoral epiphysis and Legg-Calve-Perthes disease have been suggested as possible causes for femoroacetabular impingement (FAI). The aim of our study is to describe the radiographic signs of FAI after femoral neck fractures and to compare these data with those of the contralateral hip. Method: Our institutional medical records database was retrospectively searched for patients 18-50 years old with a history of femoral neck fractures (OTA 31-B) between 2010-2019. Fifty-two patients were identified. After exclusion criteria, we detected 37 fractures in 37 patients. The mean age of 29 male and 8 female patients was 32,7 (range 18-48) years. The antero-posterior and cross- table lateral views of bilateral hip joints for all 37 patients were reviewed preoperatively and at final follow-up. The mean follow-up period was 48 months (range 6-98 months). In addition, postoperative CT-scans of these patients were also reviewed. Results: According to OTA classification subtypes, 2 subcapital (31B1), 25 transcervical (31B2) and 10 basicervical (31B3) fractures were detected. The mean alpha angle on lateral X-ray of the operated side was statistically significantly higher than the unaffected side. The mean alpha angle on CT was higher on the operated side than the unaffected side. In addition, the acetabular version angle on CT was higher on the unaffected side while acetabular depth on CT was higher on the operated side. The lateral CE angle on the AP X-ray was not different on the unaffected side compared to the operated side. Conclusion: Symptoms of impingement can be seen in patients undergoing internal fixation after femoral neck fracture, and a decrease in acetabular version and an increase in acetabular depth may be predisposing to femoral neck fracture.

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Section: Discussionmentioning

confidence: 64%

The Association Between Femoroacetabular Impingement and Internal Fixation of Femoral Neck Fractures

Kılıç¹,

Özmanevra²,

Eroğlu³

2021

HIP

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“…Multiple studies have linked hip joint morphology to FAI and osteoarthritis [ 17 , 18 , 19 , 25 ]. Regarding traumatic hip joint injury, few studies have identified proximal femoral geometry, such as neck-shaft angle and femoral anteversion, as a predisposing factor for proximal femoral fractures [ 26 , 27 , 28 ]. Two groups of scholars have indicated that hip dysplasia and FAI play a role in posterior hip dislocation [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Hip Joint Morphology and Posterior Wall Fracture: Analysis of Radiologic Parameters in Computed Tomography

Kim,

Mun,

Kim

2023

JPM

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Although numerous radiologic parameters of abnormal hip joint morphology are utilized in practice, studies on the relation of these parameters to acetabular fractures are limited. This study hypothesized that certain morphological features of hip joints are associated with acetabular posterior wall (PW) fracture patterns and aimed to identify morphological characteristics predictive of acetabular PW fracture. The records of 107 consecutive patients, who were diagnosed with acetabular fractures in a level I trauma center from August 2017 to April 2021, were initially reviewed. After excluding patients who lacked proper radiographic evaluation and had previous surgery or concomitant injury on the ipsilateral lower limb, a total of 99 patients were analyzed to investigate the morphological characteristics of the hip joint, measured in computed tomography, associated with acetabular posterior wall fracture. We included patient demographics, acetabular index (AI), sharp angle, acetabular depth-to-width ratio (AD/WR), center-edge angle (CEA), head–neck offset ratio (HNOR), acetabular head index (AHI), anterior acetabular sector angle (AASA), posterior acetabular sector angle (PASA), and acetabular version angle (AVA) in the univariate and multivariate analyses. The injury mechanism (p = 0.001) and AD/WR (p = 0.021) were predictors of PW fracture in the univariate analysis. In the multivariable analysis, injury mechanism (p = 0.011), AI (coefficient B = 0.320; Exp (B) = 1.377; p = 0.017), and AD/WR (coefficient B = 33.047; Exp (B) = 2.250 × 1014; p = 0.028) were significant predictors of PW fracture. This study highlights the importance of morphological factors, such as a larger AI and AD/WR, that may influence joint stress distribution, resulting in acetabular PW fracture. Understanding these pathomechanisms may protect the hip joint and prevent future injuries through the early identification and treatment of pathological conditions.

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“…The authors concluded that proximal femoral geometry were found to correlate with the location of hip fractures [12]. Additionally, Frost et al also evaluated the influence of acetabular and femoral versions on fractures of the femoral neck and found no correlation between proximal femur fracture type and acetabular or femoral version [21].…”

Section: Discussionmentioning

confidence: 99%

Age-related Comparison of Hip Joint Morphology in Isolated Femur Neck Fractures

et al. 2022

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Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and management differs compared to elderly. Different geometric parameters in the hip joint can play a role in fracture morphology regarding to the age. Present study aims to compare hip morphology between young and elderly population Materials and methods: 45 patients with isolated femoral neck fracture included to the study. Patients were divided into two regarding to the age; group 1 (younger than 60 yr.) and group 2 (older than 60 yr.). Garden and Pauwels classifications, Sharp angle (acetabular index-AI), acetabular depth (AD), Hip-axis length (HLA), Neck-shaft angle (NSA), Center-edge angle (CE), Singh indexes and femur head extrusion indexes were compared between groups. Results: The mean age of group 1 (22 patients) was 48 ± 10.4 while the mean age of group 2 (23 patients) was 77 ± 6.3. Significant differences found in 3 parameters; the mean HLA (13.4 ± 1.4 cm vs 12 ± 1.1 cm) (p: 0,034), the Sharp angle (37.9° ± 5° vs 40.3° ± 3°) (p: 0.047) and the CE (38.1° ± 6.2° vs 34.8° ± 4.5°) (p: 0.48) between group 1 and 2 respectively. No statistically significant difference was found in terms of AD, NSA, Singh index and extrusion index. Conclusions: Our study shows influence of proximal femoral and acetabular morphology on femoral neck fracture in young patients and may help future studies to reveal the relevance between hip morphology and fractures type.

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Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck

Cited by 7 publications

References 23 publications

The Association Between Femoroacetabular Impingement and Internal Fixation of Femoral Neck Fractures

The Association Between Femoroacetabular Impingement and Internal Fixation of Femoral Neck Fractures

The Association between Hip Joint Morphology and Posterior Wall Fracture: Analysis of Radiologic Parameters in Computed Tomography

Age-related Comparison of Hip Joint Morphology in Isolated Femur Neck Fractures

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