Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females

Sung Soo Kim; Myung Jin Lee; Hyeon Jun Kim; Jung Mo Kang

doi:10.5371/hp.2012.24.2.102

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Kim, Lee, Kim, and Kang: Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females

Original Article

Hip & Pelvis

Hip & Pelvis 2012; 24(2): 102-108.

Published online: 30 June 2012

DOI: https://doi.org/10.5371/hp.2012.24.2.102

Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females

Sung Soo Kim, MD, Myung Jin Lee, MD, Hyeon Jun Kim, MD, Jung Mo Kang, MD

Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea.

Address reprint request to Hyeon Jun Kim, MD. Department of Orthopedic Surgery, College of Medicine, Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. TEL: +82-51-240-2757, FAX: +82-51-254-6757, hyeonjun@dau.ac.kr

Received 19 January 2012 Revised 18 May 2012 Accepted 23 May 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze, by radiograph, the difference in bone mineral density (BMD) and the proximal femoral morphology of females who are over 65 years old and have had either an intertrochanteric fracture or a femoral neck fracture.

Materials and Methods

One hundred twenty-five females over 65 years of age with femoral neck fractures or intertrochanteric fractures were examined for bone mineral density using computed tomography from April 2008 to March 2011. The bone mineral density was measured by dual-energy x-ray absorptiometry (DEXA). The morphology of the proximal femur was also measured by computed tomography in the unaffected hip.

Results

In the femoral neck fracture group, the mean BMD value was 0.563 g/cm² in the femoral neck region and 0.753 g/cm² in the intertrochanteric region. In the intertrochanteric fracture group, the mean BMD value was 0.457 g/cm² in the femoral neck region and 0.656 g/cm² in the intertrochanteric region. There are statistically significant differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.029, 0.030). The mean cortical index was 0.59 in the femoral neck fracture group and 0.51 in the intertrochanteric fracture group. There are statistical differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.001).

Conclusion

The BMD of the proximal femoral neck and intertrochanteric regions of the intertrochanteric fracture group were significantly lower than that of the femoral neck fracture group. The cortical index was also significantly lower in the intertrochanteric fracture group than the femoral neck fracture group. BMD and computed tomography seem useful to check in women older than 65 who have fractures of the proximal femur.

Keywords: Femoral neck fracture, Intertrochanteric fracture, Bone mineral density, Cortical index

Figures and Tables

Fig. 1

Measurement made on computed tomography of morphologic features of the hip. Hip axis length defined as the length of head axis from the lateral aspect of the greater trochanter to the inner pelvic rim (AE), femoral neck axis length defined as the length of neck axis between the head center and the femoral medullary axis (BF), neck-shaft angle defined as the angle between femur shaft axis and femur neck axis (AFG), head offset defined as the length of head center from axis of femoral shaft. (BB').

Fig. 2

Cortical index defined as the ratio between the cortex diameter of the proximal femur and the total diameter of the proximal femur (Cortical index = (I-H)/I).

Table 1

Patient Distribution of Age, Height, Weight and BMI between Femoral Neck Fracture and Intertrochanteric Fracture Groups

^*BMI = Body Mass Index

Values are mean ± SD

Table 2

Predicting Variables and Multiple Regression Analysis Data on BMD^* of Femoral Neck Fracture and Intertrochanteric Fracture Groups

^*BMD=Bone Mineral Density, ^†BMI=Body Mass Index

Table 3

Comparison of Hip BMD^* at Different Region between Femoral Neck Fracture and Intertrochanteric Fracture Groups

^*BMD=Bone Mineral Density

Values are mean±SD

Table 4

Comparison of Hip Morphology between Femoral Neck Fracture and Intertrochanteric Fracture Groups.

^*HAL: Hip Axis Length

^†FNAL: Femoral Neck Axis Length

^‡NSA: Neck Shaft Angle

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