Association between proximal femoral geometry and incidence of proximal femoral fractures

Recently, proximal femur geometry has been identified as a risk factor for hip fracture, and studies about the association of proximal femoral geometric indices with these fractures worldwide have reported inconsistent results. In this study, this association was studied in an Iranian population. In this case control study that was performed in Ayatollah Kashani Hospital in 1395 in Shahrekord, 81 patients with proximal femur fracture were trained with low energy and 83 healthy subjects over 50 years old. After recording the demographic data, the pelvic radiograph was taken and femoral neck width (FNW), femoral Shaft Diameter (FSD), femoral neck axis length (FNAL), hip axis length (HAL) and neck shaft angle (NSA) parameters were measured in both groups using orthopedic ruler. Data analysis was performed using stata software. The mean age of case group (70.81±13.86 years) was significantly higher than control group (61.35±9.89 years) (P=0.00). Intrestingly, the mean height and weight of case group were lower than control group (P<0.05). After adjusting for age, among the geometric indices, only FNW was lower in case group than control group (P=0.01), and there was no significant difference in FNAL, HAL, FSD and NSA indices between the two groups (P>0.05). In this study older age, female sex, shorter heights, and less weight were associated with the incidence of proximal femoral fractures. Conclusively, FNAL, HAL, FSD, and NSA could not predict proximal femoral fractures in our samples. However, FNW reduction significantly increased the risk of femoral neck fractures in both male and female patients.