The association of proximal femur geometry with hip fracture risk

We aimed to discuss the risk assessments of patients with hip fractures due to the fall‐related moderate or minimal trauma and compare them with non‐fractured control patients by bone mineral density (BMD) and proximal femur geometric measurements to assess whether geometric measurements of femoral dimensions were associated with femoral strength and hip fracture risk. Forty‐two osteoporotic patients with proximal femur fracture and 40 osteoporotic non‐fractured age and gender‐matched controls were included in the study. Lunar DXA was used for BMD measurements and proximal femur geometric measurements were performed manually on direct X‐rays as hip axial length (HAL), femoral length (FL), and femoral neck width (FW). The trochanteric and total BMD values of the fracture group were significantly lower than the control group. There was a significant increase in FW/FL ratio in the fracture group that would be of specific importance for guidance: if FL values did not increase as did FW, it would point out a risk for fracture. The trochanteric BMD values were correlated with all increased measurements in the control group. There are genetically determined adaptive differences among individuals concerning bone morphology and bone mineral distribution. These different adaptations result in different bone strengths and fracture formation risk. Clin. Anat. 21:575–580, 2008. © 2008 Wiley‐Liss, Inc.

[1]  R.-S. Yang,et al.  Proximal Femoral Dimension in Elderly Chinese Women with Hip Fractures in Taiwan , 1999, Osteoporosis International.

[2]  S. Minisola,et al.  Hip axis length in an Italian osteoporotic population. , 2000, The British journal of radiology.

[3]  M. Curiel,et al.  Femoral Bone Mineral Density, Neck-Shaft Angle and Mean Femoral Neck Width as Predictors of Hip Fracture in Men and Women , 2000, Osteoporosis International.

[4]  C C Glüer,et al.  Prediction of hip fractures from pelvic radiographs: The study of osteoporotic fractures , 1994, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  T. Beck,et al.  Maternal History of Osteoporosis and Femur Geometry , 2004, Calcified Tissue International.

[6]  J. Aloia,et al.  Racial differences in femoral dimensions and their relation to hip fracture , 2005, Osteoporosis International.

[7]  T. Seeman,et al.  Hip axis length in mid-life Japanese and Caucasian U.S. residents: no evidence for an ethnic difference , 2003, Osteoporosis International.

[8]  S. Grazio,et al.  Improving Risk Assessment: Hip Geometry, Bone Mineral Distribution and Bone Strength in Hip Fracture Cases and Controls. The EPOS Study , 2002, Osteoporosis International.

[9]  H. K. Genant,et al.  Black-White Differences in Hip Geometry , 1998, Osteoporosis International.

[10]  K. Khaw,et al.  Effects of gender, anthropometric variables, and aging on the evolution of hip strength in men and women aged over 65. , 2003, Bone.

[11]  K. Faulkner.  Hip axis length and osteoporotic fractures , 1995 .

[12]  L. Mosekilde,et al.  Geometry of the proximal femur in relation to age and sex: a cross-sectional study in healthy adult danes , 2005, Acta radiologica.

[13]  J. İrdesel,et al.  The proximal femoral morphometry of Turkish women on radiographs , 2006 .

[14]  T. Yoshikawa,et al.  Do variations in hip geometry explain differences in hip fracture risk between japanese and white americans? , 1994, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[15]  O Johnell,et al.  Femoral neck geometry and radiographic signs of osteoporosis as predictors of hip fracture. , 1996, Bone.

[16]  V. Bousson,et al.  Hip Fracture Risk and Proximal Femur Geometry from DXA Scans , 2002, Osteoporosis International.

[17]  S. Cummings,et al.  Racial differences in hip axis lengths might explain racial differences in rates of hip fracture , 1994, Osteoporosis International.

[18]  C C Glüer,et al.  Simple measurement of femoral geometry predicts hip fracture: The study of osteoporotic fractures , 1993, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[19]  I. Pande,et al.  Bone Mineral Density, Hip Axis Length and Risk of Hip Fracture in Men: Results from the Cornwall Hip Fracture Study , 2000, Osteoporosis International.

[20]  G Lowet,et al.  Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. , 1997, Bone.

[21]  W. Ambrosius,et al.  Bone Mass and Structure at the Hip in Men and Women over the Age of 60 Years , 1998, Osteoporosis International.

[22]  Niklas Zethraeus,et al.  Assessment of fracture risk , 2005, Osteoporosis International.

[23]  Pamela J Schreiner,et al.  Long‐Term Prediction of Incident Hip Fracture Risk in Elderly White Women: Study of Osteoporotic Fractures , 2004, Journal of the American Geriatrics Society.