The Association Between Spinopelvic Parameters and Hip Fracture Types

The aim of this study was to investigate whether or not spinopelvic parameters alone affect the mechanism of formation and type of hip fracture. A secondary aim was to examine the impact on the formation mechanism of many factors that have been previously determined in the epidemiology of hip fractures.

The data of 200 patients who presented because of a hip fracture were retrospectively examined. The data included age, gender, body mass index, affected side and Singh Index (SI), and the measurements taken on radiographs of pelvic incidence, pelvic tilt, sacral slope, and lumbar lordosis values. The hip fractures were categorised into two groups: femoral neck and pertrochanteric.

The 100 patients in Group 1 (femoral neck) comprised 64 females and 36 males with a mean age of 75.4 ± 10.9 years, and the 100 patients in Group 2 (pertrochanteric) comprised 70 females and 30 males with a mean age of 77.6 ± 11.1 years. In Group 1, the mean values measured were pelvic incidence: 49.9 ± 11.6, pelvic tilt: 12.25 ± 7.68, sacral slope: 37.7 ± 10.1, and lumbar lordosis: 49.6 ± 13.2. In Group 2, these values were pelvic incidence: 57.2 ± 14.2, pelvic tilt: 15.62 ± 9.72, sacral slope: 41.6 ± 11.5, and lumbar lordosis: 55 ± 14.5. These values were statistically significantly higher in the pertrochanteric group than in the femoral neck group (P < 0.05).

This study demonstrated that pelvic incidence and related spinopelvic parameters are associated with hip fracture morphology. Patients with pertrochanteric fractures had significantly higher pelvic parameter values compared with those with femoral neck fractures, suggesting that increased pelvic incidence may predispose to pertrochanteric fractures.