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Published on: August 17, 2017
Study on the predictive value of femoral head HU values in hip fractures
Wenjie Qin1, Jiangyun Liao2, Jianwen Cheng1
1Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Objective:
This study investigates whether the CT Hounsfield Unit (HU) value of the femoral head can differentiate femoral neck fractures (FNF) from intertrochanteric femoral fractures (IFF), and whether it can serve as an indicator for predicting the complexity of intertrochanteric fractures.
Methods:
A retrospective analysis was conducted on 234 patients (117 with FNF and 117 with IFF), measuring the average HU value of the femoral head on preoperative CT. According to the Orthopaedic Trauma Association/AO Foundation (AO/OTA) classification, IFFs were categorized into stable (A1.1-A2.1) and unstable (A2.2-A3) types. Statistical comparisons were performed using independent sample t-tests, chi-square tests, and analysis of variance.
Results:
HU values could not distinguish FNF from IFF, but within IFFs, unstable fractures had significantly lower HU values than stable ones. Male patients had significantly higher HU values than females. ROC analysis suggested that HU values showed high specificity (91.89%) but low sensitivity (17.5%) for predicting intertrochanteric fracture stability, with moderate overall diagnostic performance (AUC = 0.6764). Gender-specific thresholds were identified but also showed moderate performance. These values support a rule-in role rather than general screening.
Conclusion:
Femoral head HU values are a reliable imaging marker for predicting intertrochanteric fracture stability and identifying high-risk patients, particularly women with unstable fractures, with consideration for sex differences in application.
