Is the femoral neck-shaft angle an independent risk factor for hip fractures? An observational study

Obande, Bernard O.; Iyidobi, Emmanuel C.; Eyichukwu, Gabriel O.; Nwadinigwe, Cajetan U.; Ekwunife, Remigus T.; Ede, Osita

doi:10.18203/issn.2455-4510.intjresorthop20194811

Cited by 2 publications

(3 citation statements)

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“…Also, surgeries such as proximal femoral valgus or varus osteotomies either for nonunion of femoral neck fractures or congenital coxa valga or vara relies on recreating the physiological FNSA. The FNSA has also been implicated in the aetiology of hip fractures [4]. The average FNSA in this work was 132.96 0 , with males having a higher angle than females.…”

Section: Discussionmentioning

confidence: 52%

“…Others are the femoral neck-shaft angle (FNSA), femoral neck length (FNL) and femoral neck diameter (FND) [1][2][3][4][5]. Femoral component head size is critical in total hip and hemiarthroplasty.…”

mentioning

confidence: 99%

“…While some studies have shown that a longer FNAL increases the risk of femoral neck fractures, others have not found any association [10,11]. Similarly, studies have shown that a larger FNSA increases the lever arm of the body weight, acting on the greater trochanter during a fall on the side [4,5]. After obtaining consent, the patient was placed supine, and the film-focus distance (FFD) was set at 100 cm.…”

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confidence: 99%

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Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

2021

IJAR

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Background: Hip surgeries such as fracture fixation, corrective osteotomy, hemiarthroplasty, or total hip arthroplasty require accurate preoperative templating for a successful outcome. Such templating is done using the proximal femur and the acetabulum radiographs, depending on the planned surgery. Understanding the normal radiographic anatomy of the proximal femur is crucial to differentiate a normal from pathological anatomy. Proximal femoral anatomic indices include the femoral head diameter, femoral neck diameter, femoral neck length, femoral offset, femoral neck axis length and the femoral neck-shaft angle. Aim: This study assesses and establishes the average values of the proximal femoral anatomy in an indigenous African adult population. Method: This cross-sectional study examined 190 normal anteroposterior (AP) radiographs of the pelvis. The mean age, weight and height of the subjects were obtained. The following proximal femoral anatomic parameters were measured: femoral neck length (FNL), femoral neck diameter (FND), femoral head diameter (FHD), femoral neck-shaft angle (FNSA), femoral offset (FO) and femoral neck axis length (FNAL). The authors compared the mean difference of the parameters between the genders and the age categories and assessed the parameter correlations with the patients’ weight and height. Results: Males constituted 63 (33.2%) of the study population. The mean age of the subjects was 51.46 years (SD = 16.37). The mean weight was 76.13 kg, while the mean height was 1.62 m. The mean values of the proximal femoral parameters were as follows: FNL 4.52cm, FND 3.42cm, FHD 4.76cm, FNSA 132.960, FO 4.09cm, and FNAL 10.34cm. Males have a significantly higher mean value in all the parameters except the FO. None of the parameters showed any significant difference among the age categories except the FNL. A post-hoc analysis showed that the difference in the FNL lies between the young and the elderly age groups. The subjects’ height correlated with all the parameters except FNSA, while the weight correlated with the FND, FNSA and FNAL. Conclusion: The proximal femoral anatomy in Africans differed from those published in foreign literature. This knowledge is crucial for implant manufacturing companies and preoperative templating for hip surgeries. KEY WORDS: Proximal femur, Anatomy, Black population.

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confidence: 52%

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Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

2021

IJAR

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Does the Proximal Femur Geometry Predict Early Functional Outcome after Plate Fixation of Geriatric Pertrochanteric Fractures?

Uzuegbunam,

Katchy,

Anyaehie

et al. 2023

Nigerian Journal of Clinical Practice

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Background: The proximal femur geometry determines the hip force distribution. The femoral neck axis length (FNAL), the hip axis length (HAL), the femoral head diameter, and the femoral neck-shaft angle (FNSA) could influence the risk and outcome of pertrochanteric fractures. Restoring these parameters to their prefracture values could predict early hip function. Aim: To determine if the postoperative proximal femur geometry of geriatric patients with plating for pertrochanteric fractures predicts the early functional outcome. Materials and Methods: The study was a prospective study carried out at the National Orthopaedic Hospital Enugu for 18 months. Geriatric patients who had Proximal Femoral Locking fixation for pertrochanteric fractures were recruited. Radiological parameters of the proximal femur in the unaffected and fixed hips were measured and compared. The functional outcomes of the patients were measured at 3 months postoperative period using the Harris hip score (HHS). Multiple linear regression was conducted on the parameters to determine the HHS. Results: Thirty patients participated in the study, with a significant difference (P < 0.001) in the mean FNSA between unaffected (M = 128.69, standard deviation (SD) =2.93) and operated hips (M = 121.81, SD = 8.86). The FNSA was the only significant predictor of hip function, with a 1-degree increase improving the HHS by 1.30. Conclusion: There is a significant difference in the FNSA between the unaffected and the operated hips. The FNSA significantly predicts the early hip function and should be reconstructed to within normal range during surgery.

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Is the femoral neck-shaft angle an independent risk factor for hip fractures? An observational study

Cited by 2 publications

References 9 publications

Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

Does the Proximal Femur Geometry Predict Early Functional Outcome after Plate Fixation of Geriatric Pertrochanteric Fractures?

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