A radiological study of proximal femoral geometry and its relationship with hip fractures in Indian population

Abstract

Context: In literature there is scarcity of documentation to test the relationship of radiological geometry of proximal femur with incidence and patterns of hip fractures especially in Indian population. In this study radiological parameters like Femoral Neck Length (FNL), Hip Axis Length (HAL), Neck Shaft Angle (NSA), Femoral Neck Diameter (FND) and Femoral Head Diameter (FHD) are measured in standardized digital pelvis radiograph of patients with hip fractures presented at a tertiary care hospital and efforts were made to establish a relationship of these parameters with the pattern of hip fractures in Indian population.Aims: The objective of the study is to investigate as to whether a particular type of proximal femoral morphology (viz. Femoral Neck Length, Hip Axis Length, Neck Shaft Angle, Femur head diameter and Femoral Neck diameter) determines and predicts the anatomical location of various types of hip fractures (1.Intracapsular (femoral neck) fractures – subtypes – subcapital; transcervical and basicervical neck femur fractures, 2. Extracapsular – subtyoes – intertrochanteric; intertrochanteric with subtrochanteric extension and subtrochanteric fractures). Settings and Design: Cross sectional observational studyMethods and Material: A cross sectional analysis was made in our hospital of a population of 100 patients with hip fractures (Intracapsular and Extracapsular). Study was conducted during 18/10/2019 to 30/09/2020. FNL, HAL, FND, FHD and NSA were measured on standardized digital pelvis radiograph by using an advanced computer software.Statistical analysis used: Independent sample t-test.Results: The sample size was divided into two age groups a younger age group (31-60years) and older age group (61-90years). For both age groups, means and standard deviations for all five parameters were calculated. We observed that for older age group, HAL is higher for extracapsular fractures than for intracapsular fractures. FNAL is increased for extracapsular fractures for the whole sample size as well as for older group. There was no significance for FHD, FND and NSA for any of the age groups for any type of fracture.Conclusions: In our study, we concluded that the HAL is significantly increased for extracapsular fractures than for intracapsular fractures in old age group of 61-90 years. FNAL is also found to be higher for extracapsular hip fractures in the same age group as well as the whole sample size. In our study, we could not establish any significant correlation between FHD, FND and NSA in any age group for any fracture type.