Chinese Medical Journal

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 131  |  Issue : 21  |  Page : 2524--2530

Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population


Zu-Sheng Hu1, Xian-Ling Liu2, Ying-Ze Zhang3 
1 Department of Orthopaedic Surgery, The Third Hospital, Hebei Medical University; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei 050051, China
2 Department of Nosocomial Infection, Anqing Hospital, Anhui Medical University, Anqing, Anhui 246003, China
3 Department of Orthopaedic Surgery, The Third Hospital, Hebei Medical University; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei 050051; Chinese Academy of Engineering, Beijing 100088, China

Correspondence Address:
Dr. Ying-Ze Zhang
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University; Key Laboratory of Biobmechanics of Hebei Province, Shijiazhuang, Hebei 050051; Chinese Academy of Engineering, Beijing 100088
China

Background: Few studies have investigated the differences in proximal femoral geometry and risk factors between patients with different types of hip fracture, especially in elderly Chinese. This study aimed to assess the differences in proximal femoral geometry parameters between patients with femoral neck fractures and patients with intertrochanteric fractures to provide guidance for individualized customized prosthesis and accurate reconstruction of proximal femurs in elderly Chinese patients. Methods: We retrospectively studied the electronic medical records of 198 elderly patients over 65 years of age who were admitted to the orthopedic department with hip fractures between January 2017 and December 2017 in The Third Hospital, Hebei Medical University. Age, fracture site, gender, and proximal femoral geometry parameters (neck shaft angle [NSA], center edge angle [CEA], femoral head diameter [FHD], femoral neck diameter [FND], femoral neck axial length [FNAL], hip axial length [HAL], and femoral shaft diameter [FSD]) were recorded. Student's t-test was used to compare the continuous variables, Chi-square test was used to analyze categorical variables, and multiple logistic stepwise regression analysis was used to evaluate the influencing factors of hip fracture type. Results: Statistically significant differences in NSA (137.63 ± 4.56° vs. 132.07 ± 4.17°, t = 1.598, P < 0.001), CEA (37.62 ± 6.77° vs. 43.11 ± 7.09°, t = 5.597, P < 0.001), FND (35.21 ± 3.25 mm vs. 34.09 ± 3.82 mm, t = 2.233, P = 0.027), and FNAL (99.30 ± 7.91 mm vs. 103.58 ± 8.39 mm, t = 3.715, P < 0.001) were found between the femoral neck fracture group and femoral intertrochanteric fracture group. FHD, FND, FSD, HAL, and FNAL were different between sexes (all P < 0.001). The greater NSA was the risk factor for femoral neck fractures (odds ratio [OR]: 0.70, P < 0.001), greater CEA and longer FNAL were risk factors for femoral intertrochanteric fractures (OR: 1.15, 1.17, all P < 0.001), and greater FND was a protective factor for femoral intertrochanteric fractures (OR: 0.74, P < 0.001). Conclusions: We demonstrate differences in geometric morphological parameters of the proximal femur in different hip fracture types, as well as an effect of sex. These differences should be considered in the selection of prostheses for fracture internal fixation and hip replacements. These data could help guide the design of individualized customized prostheses and improve the accurate reconstruction of the proximal femur for elderly Chinese hip fracture patients.


How to cite this article:
Hu ZS, Liu XL, Zhang YZ. Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population.Chin Med J 2018;131:2524-2530


How to cite this URL:
Hu ZS, Liu XL, Zhang YZ. Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population. Chin Med J [serial online] 2018 [cited 2018 Nov 16 ];131:2524-2530
Available from: http://www.cmj.org/article.asp?issn=0366-6999;year=2018;volume=131;issue=21;spage=2524;epage=2530;aulast=Hu;type=0