Proximal Hip Fracture: Does Canal Width Matter?

Area of Science:

• Orthopedics
• Radiology
• Geriatrics

Background:

• Proximal femur fractures are prevalent in the elderly population.
• Bone quality significantly influences fracture risk.
• Radiographic parameters may predict fracture types.

Purpose of the Study:

• To evaluate bone morphology parameters from pelvic anteroposterior (AP) radiographs.
• To determine predictive value of calcar-to-canal ratio (CCR), cortical thickness index (CTI), and Dorr classification for trochanteric versus sub-capital femur fractures.

Main Methods:

• Retrospective analysis of 237 medical records of patients with proximal femur fractures.
• Radiological assessment of CCR, CTI, and Dorr classification by two independent observers.
• Statistical evaluation including logistic regression and inter-rater reliability (ICC, Cronbach's alpha).

Main Results:

• 202 patients were included; mean age 81.41 years.
• Trochanteric fracture group was significantly older (p=0.005).
• Calcar-to-canal ratio (CCR) was a significant predictor (p=0.001), while CTI (p=0.78) and Dorr classification (p=0.98) were not.
• Logistic regression predicted 60.4% of fractures based on CCR.

Conclusions:

• Calcar-to-canal ratio (CCR) is a significant radiographic predictor for trochanteric femur fractures.
• Higher CCR values are associated with an increased likelihood of trochanteric fractures.
• CTI and Dorr classification showed no significant predictive value in this cohort.