Hip Geometry and Proximal Femoral Fractures among Elderly Filipino Women: A Single Centre Cross-Sectional Study

Abstract

Introduction: Few controlled studies explore proximal femoral geometry and association with femoral neck (FN) or intertrochanteric (IT) fractures, especially among the elderly Filipino population. Previous reports, however, still reveal multiple inconsistencies. The objective of the study is to establish a possible association between radiographic hip geometry and proximal femoral fractures based on measurements taken from elderly Filipino women. Materials and methods: This is a cross-sectional study of 182 Filipino women ≥ 60 years old at a single institution last 2019-2020. Patients were divided into groups with femoral neck fractures (n=84), intertrochanteric fractures (n=64), and those without diagnosed hip fractures (n=34). Standard pelvic radiographs with control of hip internal rotation was done and the following radiographic parameters were compared: hip axis length (HAL), femoral neck length (FNL), neck shaft angle (NSA), horizontal offset (HO), femoral head diameter (FHD), and femoral neck diameter (FND). Results: Data suggests that an increased FND increased the risk for acquiring both femoral neck (OR = 1.31, 95% CI 1.06-1.62; p=.011) and intertrochanteric fractures (OR: 1.22, 95% CI 1.07-2.16; p=0.018). For intertrochanteric fractures alone, a wider NSA (OR 1.27, 95% CI 1.02-1.58, p=0.033) and larger HO (OR 1.29, 95% CI 1.02-1.64, p=0.036) also increased the risk for this fracture type while a longer HAL was protective (OR 0.85, 95% CI 0.73-0.98, p=0.30). Other radiographic parameters and ratios revealed no association. Conclusion: Results show that there are certain hip geometric parameters that play a role in the risk and incidence of developing femoral neck or intertrochanteric fractures. These measurements may aid in identification of patients at risk. This study may act as a guide for future implant design and increase accuracy of hip reconstruction among elderly Filipino women.