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

• Published in: BMC musculoskeletal disorders Vol. 18; no. 1; p. 305
• Main Authors: Zhuang, Huafeng, Li, Yizhong, Lin, Jinkuang, Cai, Donglu, Cai, Siqing, Yan, Lisheng, Yao, Xuedong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18-07-2017; BioMed Central; BMC
• Subjects: Absorptiometry, Photon - methods; Age; Aged; Aged, 80 and over; Body mass; Body mass index; Bone density; Bone Density - physiology; Bone mineral density; Care and treatment; Complications and side effects; Diagnosis; Dual energy X-ray absorptiometry; DXA; Female; Femoral Neck Fractures - diagnostic imaging; Femoral Neck Fractures - etiology; Femur; Femur - diagnostic imaging; Femur - physiology; Femur Neck - diagnostic imaging; Femur Neck - physiology; Fractures; Geometry; Geriatrics; Hip; Hip fracture; Hip fractures; Hip Fractures - diagnostic imaging; Hip Fractures - etiology; Hip joint; Humans; Male; Middle Aged; Mortality; Musculoskeletal diseases; Osteoporosis; Physiological aspects; Risk Factors; Statistical analysis; Studies; Thinning; China; Geometry; Osteoporosis; Hip fracture; Bone mineral density; DXA
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-017-1669-z

This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures.
One 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/m
. 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/m
. 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.
The 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.
Cortical thickness thinning in the intertrochanteric region may be one of the relevant factors causing different types of hip fractures, especially in elderly patients.