Cortical thickness in the intertrochanteric region may be relevant to hip fracture type

Huafeng Zhuang,Lisheng Yan,Yizhong Li,Siqing Cai,Xuedong Yao,Jinkuang Lin,Donglu Cai

doi:10.1186/s12891-017-1669-z

Abstract

BackgroundThis study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures.MethodsOne hundred and seventeen patients were divided into femoral neck and trochanteric fracture groups. There were 69 patients with femoral neck fractures, 20 men and 49 women with an average age of 75.1 ± 9.6 years and an average body mass index (BMI) value of 21.6 ± 4.1 kg/m2. The trochanteric group consisted of 48 patients, 16 men and 32 women with an average age of 78.1 ± 9.1 years and an average BMI value of 21.5 ± 4.3 kg/m2. All patients underwent dual-energy X-ray absorptiometry (DXA) of the contralateral hip; hip structural analysis (HSA) software was used to analyze the femoral geometry parameters, including hip axis length (HAL), neck-shaft angle (NSA), cross-sectional area (CSA), the cross-sectional moment of inertia (CSMI), the buckling ratio (BR), and cortical thickness.ResultsThe cortical thickness in the intertrochanteric region was reduced in the trochanteric fractures group compared to the femoral neck fracture group (P < 0.05). There were no statistically significant differences (P > 0.05) in gender, age, height, weight, or BMI between the two groups. In addition, no statistically significant differences (P > 0.05) were found in the CSA, CSMI, or BR of the femoral neck or the intertrochanteric region between the two groups. There were no statistically significant differences (P > 0.05) in femoral neck cortical thickness between the two groups.ConclusionsCortical thickness thinning in the intertrochanteric region may be one of the relevant factors causing different types of hip fractures, especially in elderly patients.

Highlights

This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures
bone mineral density (BMD) There were no significant differences in BMD in the femoral neck region, femoral intertrochanteric region, femoral Ward’s region, femoral intertrochanteric region, and total hip region (p > 0.05; Table 2)
There were no significant differences in cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and buckling ratio (BR) in the neck region (p > 0.05)

Summary

Introduction

This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures. For the lumbar spine measurement, the patient lay down on the center of the testing platform, the feet were put on the foot care, hip flexion was 90°, the lumbar intervertebral discs were perpendicular to the bed, and the spine was in the center of the bed and straight. Both sides of the iliac crests of T12 and L5 were displayed when scanning.

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Results

Discussion

Conclusion