Does Proximal Hip Geometry Affect Fracture Type in The Elderly Population?
Abstract Background The aim of this study was to determine the differences in proximal femoral geometric (PFG) parameters between patients with femoral neck fractures(FNFs) and patients with intertrochanteric fractures (ITFs). Methods We retrospectively evaluated 114 patients (33 FNFs, 81 ITFs.) who were hospitalized secondary to hip fractures. Patients were divided into two groups: patients with FNFs and patients with ITFs. The PFG parameters (the neck shaft angle, center-edge angle, femoral head diameter, femoral neck diameter, neck/head ratio, femoral neck axial length, femoral shaft diameter, hip axial length, and neck/hip length ratio) were measured on the hip joint radiographs. Results There were no statistically significant differences in age and gender between the FNF and ITF groups. In addition, there were no statistically significant differences in the PFG parameters between the FNF and ITF groups except in the neck/hip length ratio (NHLR) (0.86 ± 0.03 vs 0.84 ± 0.03, p = 0.05). When a 3-way multivariate analysis was performed according to gender, fracture type, and fracture site, the femoral head diameter, femoral neck diameter, femoral neck axial length, femoral shaft diameter, hip axial length, and NHLR were found to be greater in females than in males, and a statistically significant relationship was found between gender and these variables. Conclusion Only the NHLR was significantly higher in the ITF group, so this study revealed that a higher NHLR, which is the presence of a longer hip axis combined with a shorter neck axis, is a risk factor for ITF after a minor trauma.