A New Definition of Hip Geometry Measures to Evaluate Hip Fracture Risk - Abstract
Background: Our goal was to test the influence of the anatomical position of the head in relation to the femoral neck on the quality of Hip Geometry (HG) for a better diagnosis of people running risk of femoral neck and trochanter fractures. The previously used measures of HG are defined by the position of the neck in relation to the femoral diaphisis. Methods: We tested HG measures with an anatomical (CN axis) and non-anatomical relation of the femoral neck and head (NN´axis). The test we have performed on a clearly defined sample of 171 white females. Results: Femoral neck fracture: CNAL ? 78.88 mm, AUC 0.67, 95% CI 0.64-0.84, sensitivity 0.76 and specificity 0.58, p<0.001; CNTMA ? 47.33 mm, AUC 0.70; 95% CI 0.56-0.82, 0.69 and 0.67, p=0.001; CNS angle ? 127.5°, AUC 0,66, 95% CI 0.55-0.77, 0.57 and 0.69, p=0.01. NN´AL ? 79.12 mm, AUC 0.66; 95% CI 0.55-0.78, 0.55 and 0.69, p= 0.008; NN´TMA ? 44.20 mm, AUC 0.53; 95% CI 0.41-0.65, 0.43 and 0.67 p=0.668. NS angle ? 123.50°, AUC 0.59; 95% CI 0.47-0.72, 0.57 and 0.58, p= 0.149. Neither the measures CN axis nor NN´ axis don’t diagnose the risk of a trochanter fracture. Conclusion: The measures of HG defined by an anatomical relation between the neck and head are better at diagnosing people running risk of femoral neck fractures than previously used measures. Hip Geometry doesn’t influence the biomechanics of trochanter fractures. Anatomical measures better evaluate the risk of femoral neck fractures than the previous. These measures are usable in lowering the amount and severity of femoral neck fractures.