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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017
Morphometric and Bone Quality Correlates of Elderly Hip Fracture Types
1Department of Orthopedics and Traumatology, Erzurum City Hospital, Cat Road Street, 25240 Erzurum, Turkey.
Background:
Proximal femur fractures in elderly patients are determined by patient age, femoral morphometry, and radiographic bone quality. The Dorr classification, Singh index, and the canal-to-bone ratio (CBR) are commonly used to evaluate cortical integrity and trabecular structure.
Methods:
A retrospective analysis was performed on 322 patients with proximal femur fractures. Radiographic parameters included collodiaphyseal angle (CDA), center-edge angle (CEA), femoral head diameter (FHD), femoral neck diameter (FND), femoral neck length (FNL), femoral offset (FO), and cortical widths at supra- and infra-minor trochanter levels. Bone quality was assessed using the Dorr classification, Singh index, and CBR. Statistical analyses comprised the Shapiro-Wilk test for normality, Kruskal-Wallis test, Dunn's post hoc comparisons with Bonferroni correction, and chi-square test for categorical variables. Interobserver reliability was verified.
Results:
Age (p = 0.001), CDA (p = 0.020), FNL (p = 0.005), and FO (p = 0.002) differed significantly by fracture type. Subtrochanteric fractures occurred more often in relatively younger patients (mean age: 73.3 ± 11.0 years) and were associated with lower FNL and FO values. Dorr Type C morphology showed a significant association with basicervical fractures (χ2 = 15.93, p = 0.043). The Singh index (p = 0.0005) and CBR (p = 0.0045) were also significantly related to fracture patterns, reflecting trabecular bone loss and cortical thinning, particularly in subcapital and subtrochanteric fractures.
Conclusion:
Proximal femoral morphometry and bone quality indices may help anticipate fracture localization and support clinical decision-making in elderly hip fractures.
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