The impact of proximal femur geometry on fracture type - A comparison between cervical and trochanteric fractures with two parameters

Abstract

Introduction: Only a few studies have tested the ability of proximal femur geometry parameters to discriminate between cervical hip fractures and those of the trochanter. The main objective of this study was to evaluate the geometrical differences between these two fracture types by measuring the neck shaft angle (NSA) and the femoral neck axis length (FNAL). We also compared the distributions of these parameters and the distributions of fracture type by gender. Material and Methods: A retrospective analysis was made in a population-based material of 428 hip fractures collected during a two-year period from 1999 to 2000 (323 women and 105 men aged 65 years or older). NSA and FNAL were manually measured from pelvic radiographs. Results: No significant differences in NSA or FNAL were found between cervical and trochanteric hip fractures in women or in men. Men had significantly higher NSA and FNAL than women. Age was not related to these geometrical parameters. The distributions by fracture type were similar in both genders. Conclusions: The different pathogenesis of cervical and trochanteric hip fractures cannot be explained by NSA or FNAL. A standardized measurement setup is needed when evaluating the role of hip geometry in fracture patients.