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Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
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Comparative evaluation of radiographic morphologic parameters for predicting subsequent contralateral fragility hip
Witit Pothong1, Nath Adulkasem2
1Orthopaedics Unit, Lamphun Hospital, Lamphun, Thailand.
International Orthopaedics
|March 29, 2023
Summary
Radiographic parameters like cortical thickness index (CTI) can predict subsequent contralateral hip fractures in osteoporotic patients. CTI showed the highest predictive value, offering a preliminary tool for risk assessment in elderly individuals.
Area of Science:
- Orthopedics
- Radiology
- Geriatrics
Background:
- Subsequent contralateral fragility hip fracture (SCHF) poses significant morbidity and mortality risks for osteoporotic patients.
- Early identification of patients at high risk for SCHF is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive capability of radiographic morphologic parameters of the proximal femur for SCHF.
- To identify which parameters are most effective in predicting SCHF in patients with unilateral hip fractures.
Main Methods:
- Retrospective observational study of 459 unilateral fragility hip fracture patients (April 2016 - December 2021).
- Measurement of canal-calcar ratio (CCR), cortical thickness index (CTI), canal-flare index (CFI), and morphological cortical index (MCI) from contralateral proximal femur radiographs.
- Multivariable logistic regression analysis to determine adjusted predictive abilities, controlling for age, BMI, visual impairment, and dementia.
Main Results:
- 49 patients (10.7%) experienced SCHF.
- All measured radiographic parameters showed excellent predictive performance for SCHF.
- Adjusted odds ratios for SCHF were highest for CTI (35.05), followed by CFI (13.32), MCI (5.60), and CCR (4.50).
Conclusions:
- CTI demonstrated the strongest predictive power for SCHF, followed by CFI, MCI, and CCR.
- These radiographic morphologic parameters offer a valuable preliminary tool for predicting SCHF risk in elderly patients with unilateral hip fractures.
