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Proximal femur geometry assessed by hip structural analysis in hip fracture in women

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Abstract

Introduction

In the pathogenesis of hip fracture, proximal femur geometry plays a key role as well as decreased bone density. The hip structural analysis (HSA) processes dual energy X-ray absorptiometry (DXA) images containing information on the geometry closely related to the strength of the proximal femur. The objective of this study was to investigate bone mineral density (BMD) and mechanical properties of the proximal femur in a group of women with a previous contralateral hip fragility fracture compared to women without history of hip fracture.

Materials and methods

In a population of postmenopausal women, we evaluated bone density by DXA and bone geometry using the HSA parameters (femoral strength index, cross-sectional moment of inertia, cross-sectional area, section modulus, and buckling ratio) including hip axis length (HAL) and neck shaft angle.

Results

Of a total of 62 postmenopausal women, twenty-six with a history of hip fracture had a mean femoral neck BMD significantly lower in comparison with 36 women in the control group (0.703 versus 0.768 g/cm2, p = 0.0347). There was a statistically significant difference between groups also for HAL (106.75 mm in fracture group versus 100.93 mm in control group, p = 0.0015).

Discussion and conclusions

Our results demonstrated that all the geometrical parameters resulted worst into the group of patients with history of hip fracture, even though only the HAL was significantly lower in control subjects. In our opinion HSA is useful to characterize the risk of hip fracture in postmenopausal women, providing additional data on the spatial distribution of bone mass strongly related to bone strength.

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Authors and Affiliations

  1. Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy

    Giovanni Iolascon, Antimo Moretti & Giovanni Cannaviello

  2. Centre for the Study of Osteoporosis and Metabolic Bone Disease, Section of Orthopaedic and Traumatology, Treviglio-Caravaggio Hospital, Bergamo, Italy

    Giuseppina Resmini

  3. Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy

    Francesca Gimigliano

Authors
  1. Giovanni Iolascon
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  2. Antimo Moretti
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  3. Giovanni Cannaviello
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  4. Giuseppina Resmini
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  5. Francesca Gimigliano
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Corresponding author

Correspondence to Giovanni Iolascon.

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On behalf of all authors, the corresponding author states that there is no conflict of interest. No funding was received in support of this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Iolascon, G., Moretti, A., Cannaviello, G. et al. Proximal femur geometry assessed by hip structural analysis in hip fracture in women. Aging Clin Exp Res 27 (Suppl 1), 17–21 (2015). https://doi.org/10.1007/s40520-015-0406-4

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  • DOI: https://doi.org/10.1007/s40520-015-0406-4

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