Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2021 Jan;34(1):1-7. Korean.
    Published online Jan 25, 2021.
    https://doi.org/10.12671/jkfs.2021.34.1.1
    Copyright © 2021 The Korean Fracture Society. All rights reserved.
    Original Article

    Clinical Outcomes and Radiologic Characteristics of Insufficiency Femoral Neck Fracture in Elderly Patients

    Hee-Uk Ye, M.D., Kyung-Jae Lee, M.D., Ph.D., Byung-Woo Min, M.D., Ph.D., Kyung-Hwan Lim, M.D., Beom-Soo Kim, M.D., Ph.D. and Young-Hoon Kim, M.D.
      • Department of Orthopedics, Keimyung University Dongsan Hospital, Daegu, Korea.
    • Correspondence to: Kyung-Hwan Lim, M.D. Department of Orthopedics, Keimyung University Dongsan Hospital, 1035 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-258-4770, Fax: +82-53-258-4773, Email: osmdlkh@gmail.com
    Received October 15, 2020; Revised November 08, 2020; Accepted November 25, 2020.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    In elderly patients, femoral neck insufficiency fractures that occur without a history of trauma are difficult to diagnose and treat, so it is emphasized that early suspicion of fractures and additional diagnostic tests are conducted.

    Materials and Methods

    Between December 2010 to December 2019, 12 femoral neck insufficiency fractures (group 1) were evaluated by comparing them with 50 traumatic femoral neck fractures of a similar age. Along with demographic data, neck cortical thickness, shaft cortical thickness, head diameter, neck width, trochanter width, shaft width, neck-shaft angle, hip axis length, femoral neck index on the simple radiographic image were compared.

    Results

    Seven of the 12 cases were non-displaced fractures, and it took an average of 19.2 days to diagnose the fracture after the symptoms occurred. The height was smaller than the control group at 149.1 cm in group 1 and 157.2 cm in group 2 (p<0.001). The cortical thickness of the medial femoral neck showed significant differences between the two groups: 3.16 mm in group 1 and 4.11 mm in group 2 (p=0.004). There was no statistical difference in the other measurements.

    Conclusion

    Femoral neck insufficiency fracture often has a delayed diagnosis because of the characteristics of the fracture. The cortical thickness of the medial femoral neck in simple radiographic images can help suspect femoral insufficiency fractures in elderly patients when considered with detailed medical history taking and a physical examination.

    Keywords
    Femoral neck; Insufficiency fracture; Simple radiographic measurement

    Figures

    Fig. 1
    Diagram of the proximal femur showing the definition of the bone geometric and architectural parameters. HD: head diameter, NW: neck width, TW: trochanter width, NC: neck cortical thickness, HAL: hip axis length, Angle A: neck-shaft angle, SLC: shaft lateral cortical thickness, SW: shaft width, SMC: shaft medial cortical thickness.

    Fig. 2
    Diagram of the proximal femur showing the definition of the bone geometric and architectural parameters. HD: head diameter, NW: neck width, TW: trochanter width, NC: neck cortical thickness, HAL: hip axis length, Angle A: neck-shaft angle, SLC: shaft lateral cortical thickness, SW: shaft width, SMC: shaft medial cortical thickness.

    Tables

    Table 1
    Demographic Data

    Table 2
    Radiologic Parameters

    Notes

    Financial support:None.

    Conflict of interests:None.

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    MeSH Terms
    Aged*
    Delayed Diagnosis
    Diagnostic Tests, Routine
    Femoral Neck Fractures*
    Femur
    Femur Neck*
    Fractures, Stress
    Head
    Hip
    Humans
    Medical History Taking
    Neck
    Physical Examination
    Metrics
    Share
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    Tables
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