Proximal femoral geometry and hip fractures

There is increasing evidence that proximal femoral geometry has an important role in the aetiology of hip fractures. We performed a simple radiological study to investigate the relationship between proximal femoral geometry and intracapsular and extracapsular fractures of the proximal femur. Measurements of proximal femoral geometry were made on pelvic radiographs on the contralateral hip of 50 consecutive patients with intracapsular and 50 with extracapsular fractures. The groups were matched for age and sex with a mean age of 79 and a female :male ratio of 4 :1. There were no statistical differences in head diameter, neck width or Head Trochanter Length between the two groups of fractures. Hip Axis Length, neck length and the neck length :width ratio were significantly greater in the intracapsular group, suggesting an aetiological link. This may have implications for future screening and prevention of proximal hip fractures, particularly intracapsular fractures.