The association of proximal femur geometry with hip fracture risk

Dincel, Veysel Ercan; Şengelen, Meltem; Sepici, Vesile; Çavuşoğlu, Turgay; Sepici, Behcet

doi:10.1002/ca.20680

Cited by 29 publications

(27 citation statements)

References 22 publications

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“…It has been established that the thickness in the femoral neck coincides with diminished production of endosteal bone, having as a result a loss of bone density (Bone Mineral Density -BMD), and a rise in sub periosteal bone, secondary to the production generated at growth (Dinçel et al, 2008). In a retrospective study, El-Kaissi et al (2005) demonstrated that Caucasian postmenopausal women with hip fractures have a longer length and axis of the femoral neck, compared to women without fractures, determining that, independent of their age, height and bone density, the risk of hip fracture increases by 24% with every one millimeter increase in the thickness of the femoral neck.…”

Section: Discussionmentioning

confidence: 99%

Proximal Femoral Epiphysis Anatomy in Chilean Population: Orthopedic and Forensic Aspects

Osorio¹,

Schorwer²,

Coronado

et al. 2012

Int. J. Morphol.

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SUMMARY:From a biomechanical standpoint, bone geometry and density are factors correlated to the bone resistance of the femur when supporting body weight, with geometric parameters like the diameter of the femoral head and neck, the length of the femoral neck, and the femoral neck angle as determinant factors in the incidence of hip fractures, which increase in frequency and seriousness in osteoporotic patients. In Chile, morphometric data that contributes to relating the anatomy of the proximal epiphysis of the femur as an associated factor in hip fractures does not exist; likewise, there are no anthropometric indexes that may contribute to the forensic sciences. The purpose of this study is to establish average measurements of the proximal epiphysis of the femur in the adult Chilean population. Descriptive Study. The proximal epiphyses of 81 dry adult femurs were analyzed (44 right and 37 left bones), measuring the following parameters: length of the femoral neck (LN), femoral neck angle (FNA), circumference of the femoral head (CH) and circumference of the femoral neck (CN). The statistical relationship between the measurements and the side of each sample was analyzed (t-test p=0.05). The average lengths were LN= 3.59cm (±0.43 cm); FNA= 124.17º (±6.37º), CH= 14.34 cm (±1.27 cm) and CN= 9.7 cm (±0.87 cm). No significant differences between the left and right sides were found. Average numbers were obtained for the anatomy of the proximal femoral epiphysis from a sample in the Chilean population. With the data obtained, we propose to carry out anatomoclinical, epidemiologic and forensic studies in this population.

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Section: Discussionmentioning

confidence: 99%

Proximal Femoral Epiphysis Anatomy in Chilean Population: Orthopedic and Forensic Aspects

Osorio¹,

Schorwer²,

Coronado

et al. 2012

Int. J. Morphol.

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“…This is because a longer lever arm is considered to increase the risk of fracture on impact [3]. As HAL increases, the lever arm between the hip center and the femur extends and fractures can occur with the excess load on the proximal femur [9]. Although patients with femoral neck fractures have been reported to show longer HAL [11,[16][17][18], when compared with patients with trochanteric fractures, no significant differences in lever arm indices such as HAL, FNAL, or head offset were found between groups in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, risk factors of a proximal femoral fracture may be associated with femoral geometry and BMD values [9]. Several studies have shown that variations in femoral geometric measurements such as hip axis length (HAL) [14], neck shaft angle (NSA) [2], and femoral neck width are associated with increased risk of proximal femoral fractures [16,18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures

Maeda

Sugano

Saito

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Many studies that analyzed bone mineral density (BMD) and skeletal factors of hip fractures were based on uncalibrated radiographs or dual-energy xray absorptiometry (DXA). Questions/purposes Spatial accuracy in measuring BMD and morphologic features of the femur with DXA is limited. This study investigated differences in BMD and morphologic features of the femur between two types of hip fractures using quantitative computed tomography (QCT). Patients and Methods Forty patients with hip fractures with normal contralateral hips were selected for this study between 2003 and 2007 (trochanteric fracture, n = 18; femoral neck fracture, n = 22). Each patient underwent QCT of the bilateral femora using a calibration phantom. Using images of the intact contralateral femur, BMD measurements were made at the point of minimum femoral-neck cross-sectional area, middle of the intertrochanteric region, and center of the femoral head. QCT images also were used to measure morphologic features of the hip, including hip axis length, femoral neck axis length, neck-shaft angle, neck width, head offset, anteversion of the femoral neck, and cortical index at the femoral isthmus.Results No significant differences were found in trabecular BMD between groups in those three regions. Patients with trochanteric fractures showed a smaller neck shaft angle and smaller cortical index at the femoral canal isthmus compared with patients with femoral neck fractures. Conclusions We conclude that severe osteoporosis with thinner cortical bone of the femoral diaphysis is seen more often in patients with trochanteric fracture than in patients with femoral neck fracture.

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“…1,17 Besides in a recent study, we evaluated the bone morphogenetic proteins, mostly focusing on the usefulness of biochemical markers for risk assessment. 16 Here, our goal was to better understand IDO's role in bone metabolism via two different anatomical types of hip fracture groups compared to healthy control group.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The complex pathogenesis of osteoporosis is determined by the interaction of genetic, metabolic, and multiple environmental factors. Besides, free radicals and reactive oxygen species may involve in bone metabolism in which oxidative stress promotes the apoptosis of osteoblasts and the survival of osteoclasts.…”

mentioning

confidence: 99%

Evaluation of Tryptophan/Kynurenine Pathway Relevance With Immune System Biomarkers of Low Energy Trauma Hip Fractures in Osteoporotic Patients

et al. 2017

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Objectives: This study aims to evaluate tryptophan degradation and clarify whether altered levels of kynurenine and tryptophan (Kyn/Trp) ratio could be correlated to osteoporotic hip fractures via immune system. Patients and methods:The study included 60 patients with osteoporotic hip fracture (20 males, 40 females, mean age 76.6±6.9 years; range 59 to 95 years). Patients were divided into two as patients with collum femoris fractures (group 1; n=23) and intertrochanteric fractures (group 2; n=37). Fifteen healthy subjects without any fracture were selected as control group (group 3; 3 males, 12 females; mean age 69.7±8.4; range 60 to 86 years). All fractures were simple falls due to low energy trauma. Bone mineral density measurements were performed with Lunar dual energy X-ray absorptiometry. Kyn/Trp levels were measured by high performance liquid chromatography. Interleukin (IL)-6 and IL-1 beta levels were measured with solid-phase sandwich enzyme-linked immunosorbent assay. Results: All bone mineral density values were in agreement for osteoporosis and there was no significant difference between the two groups. Higher Kyn/Trp ratios were observed in groups 1 and 2 compared to group 3. This difference was more significant in group 1 (p=0.0001) than that in group 2 (p=0.048). Also, group 1 had significantly higher Kyn/Trp ratio than group 2 (p=0.011). There were significantly higher IL-6 and lower IL-1 beta levels both in groups 1 and 2 compared to group 3 (p=0.0001). There was no significant difference between group 1 and group 2 in terms of IL-6 and IL-1 beta levels. There was positive correlation with Kyn/Trp ratio (r=0.581, p=0.004) in group 2. Also, significant correlation was detected between IL-6 and IL-1 beta levels in the same group (r=0.665, p=0.036). Conclusion: Both increased degradation of tryptophan and ratio of Kyn/Trp indicate the relationship of immune activation with bone healing.

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The association of proximal femur geometry with hip fracture risk

Cited by 29 publications

References 22 publications

Proximal Femoral Epiphysis Anatomy in Chilean Population: Orthopedic and Forensic Aspects

Proximal Femoral Epiphysis Anatomy in Chilean Population: Orthopedic and Forensic Aspects

Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures

Evaluation of Tryptophan/Kynurenine Pathway Relevance With Immune System Biomarkers of Low Energy Trauma Hip Fractures in Osteoporotic Patients

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