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Gumuchdjian DA, Waltenspül M, Dietrich M, Kabelitz M. Hip Axis Length and Femoral Neck-Shaft Angle as Risk Factors for Proximal Femur Fractures in Octogenarians to Centenarians. J Clin Med 2024; 13:4071. [PMID: 39064111 PMCID: PMC11278120 DOI: 10.3390/jcm13144071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/06/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: The prevention of proximal femoral fractures among people of very advanced age is relevant as they are common and increasing in number. The aim of this study was to determine if the hip axis length (HAL) and the neck-shaft angle (caput-collum-diaphyseal CCD) are risk factors for those fractures among people aged 80 years and over. Consequently, it was additionally analysed if these parameters are associated with a certain fracture type. (2) Methods: Anteroposterior radiographs of the pelvis were collected to form three groups (femoral neck fractures (FNFx), trochanteric fractures (TFx) and non-fractured femora (NFx)). Two independent blinded observers separately conducted each measurement of the HAL and CCD. Statistical analysis was performed to determine the association between the measured parameters and type of fracture. (3) Results: One hundred and fifty patients (50 per group) were examined, of which the mean age was 92.7 ± 3.5 (range 81-104) years. Both the HAL and CCD of the FNFx group were significantly larger than in the TFx group (p = 0.013, 0.003). The CCD was higher in the FNFx than that of the NFx group (p = 0.001). No further significant differences of HAL and CCD were observed between the groups. (4) Conclusions: For people aged 80 years and over, an increased HAL represented no risk factor for proximal femur fractures, and a large HAL was associated with an increased occurrence of FNFx instead of TFx. A large CCD was associated with an increased risk of suffering a femoral neck fracture, showing evidence of the CCD being a risk factor for the extremely old population.
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Affiliation(s)
| | | | | | - Method Kabelitz
- Clinic for Orthopaedics, Trauma Surgery and Hand Surgery, Stadtspital Zürich, Tièchestrasse 99, 8037 Zürich, Switzerland; (D.A.G.); (M.W.); (M.D.)
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Vlachos C, Ampadiotaki MM, Papagrigorakis E, Galanis A, Zachariou D, Vavourakis M, Rodis G, Vasiliadis E, Kontogeorgakos VA, Pneumaticos S, Vlamis J. Distinctive Geometrical Traits of Proximal Femur Fractures-Original Article and Review of Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2131. [PMID: 38138234 PMCID: PMC10744519 DOI: 10.3390/medicina59122131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The incidence of proximal femoral fractures is escalating rapidly, generating a significant challenge for healthcare systems globally and, carrying serious social and economic implications. The primarily object of this study was to discover potential distinguishing factors between fractures occurring in the femoral neck and trochanteric region. Materials and Methods: We performed a prospective cohort study of the radiographic images of 70 people over 65 years of age who were admitted to the orthopedic department with hip fracture and who fulfilled our eligibility criteria. Neck Length (NL), Offset Lenth (OL), Hip Axis Length (HAL), Neck Shaft Angle (NSA), Wiberg Angle (WA), Acetabular Angle (AA), Femoral Neck Diameter (FND), Femoral Head Diameter (FHD), Femoral Shaft Diameter (FSD), Femoral Canal Diameter (FCD) and Tonnis classification were recorded. For the comparison of the categorical variables, Pearson's χ2 criterion was used, while Student's t-test was applied for the comparison of means of quantitative variables across fracture types. Results: There were no statistically significant variances observed while comparing the selected geometric parameters of the proximal femur with the type of fracture. This finding was reaffirmed in relation to age, gender, and Tonnis classification. However, a moderate correlation was noted, revealing comparatively reduced values of HAL, FHD, and FND in women as opposed to men. Conclusions: The inability of our research to establish the differentiative geometric factors between femoral neck and trochanteric fractures underscores the need for further investigations, which would take into consideration the intrinsic characteristics of the proximal femur.
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Affiliation(s)
- Christos Vlachos
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | | | - Eftychios Papagrigorakis
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - Athanasios Galanis
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - Dimitrios Zachariou
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - Michail Vavourakis
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - George Rodis
- Department of Radiology, KAT General Hospital, 14561 Athens, Greece;
| | - Elias Vasiliadis
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - Vasileios A. Kontogeorgakos
- 1st Orthopedic Department, National and Kapodistrian University of Athens, Attikon General University Hospital, 12462 Chaidari, Greece;
| | - Spiros Pneumaticos
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
| | - John Vlamis
- 3rd Orthopedic Department, National and Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.P.); (A.G.); (D.Z.); (M.V.); (E.V.); (S.P.); (J.V.)
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