Influence of bone mineral density and hip geometry on the different types of hip fracture.

Lisheng Yan,Xuedong Yao,Yuancheng Pan,Huafeng Zhuang,Peiwen Wang,Yanjun Zeng,Jinkuang Lin,Yizhong Li,Siqing Cai

doi:10.17305/bjbms.2016.638

Abstract

The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

Highlights

Fragility hip fracture is the most critical complication of osteoporosis
We proved in this study that in the fragility femoral neck fracture group and trochanteric fracture group, the bone mineral density (BMD) of femoral neck was significantly lower compared with the normal group; the cross surface area (CSA) and cortical thickness (CT) of femoral neck and trochanteric region were lower, but the buckling ratio (BR) was significantly higher
There was no significant difference in the BMD of femoral neck and hip structure parameters in femoral neck fracture group and trochanteric fracture group

Summary

Introduction

Fragility hip fracture is the most critical complication of osteoporosis. There are about 1,500,000 patients with fragility hip fracture in the world in 2000. The morbidity of hip fracture in China is ascending. It ascended at a rate of about 10% each year in 2002-2006 [3]. The known risk factors for hip fractures are low bone mineral density (BMD) and change in the hip geometry. The risk of hip fracture increases by 2.6 times with every decrease of one standard deviation in the BMD of femoral neck [6]. The structures of proximal femur such as hip axis length, neck axis length, neck width, neck-shaft angle and cortical thickness are related to type of hip fracture [7,8,9,10].

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Conclusion