Proximal Femoral Bone Geometry in Osteoporotic Hip
Fractures in Thailand
Tanawat Vaseenon MD*, Sirichai Luevitoonvechkij MD*,
Sirianong Namwongphrom MD, PhD**, Sattaya Rojanasthien MD*
Affiliation :
* Department of Orthopaedics, Faculty of Medicine,Chiang Mai University, Chiang Mai, Thailand
** Nuclear Medicine Unit, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Background : A number of different bone geometries have been reported to be correlated with osteoporosis, bone mineral
density and fractures. Those correlations are used for diagnosis, treatment and prediction of fracture risk in osteoporosis
cases. However, there have been no studies of significant bone parameters predicting osteoporosis and hip fracture in
Thailand.
Objective : To evaluate the correlation between geometric parameters of the proximal femur and both the Singh index and
bone mineral density as well as to investigate the relationship between those two metrics and osteoporotic hip fracture in
the Thai population.
Material and Method: Forty-four Thai patients with osteoporotic hip fractures and forty-five healthy Thai people matched
for age and gender were included in the present study. Bone mineral density and bone geometry from plain hip radiographs
of non-fracture sites in the fracture group and proximal femur radiographs of the same site in the healthy group were
measured. That data were analyzed to determine levels of correlation. Bone geometries were also analyzed to determine
hip fracture predictive capacity.
Results : Correlation between the Singh index and bone mineral density was significant (p<0.01), with a moderate degree
of agreement. The radiograph measurement of the width of the femoral medial neck cortex was the only parameter which
was statistically significantly correlated with both osteoporosis and with osteoporotic hip fracture (p = 0.014 and p = 0.035,
respectively). Each 1 mm reduction in the width of the femoral medial neck cortex increased the osteoporotic hip fracture
risk by a factor of 2.7 (OR = 0.37, 95% CI = 0.15-0.93).
Conclusion : In the Thai population, bone geometry from plain radiographs can help predict the risk of osteoporotic hip
fracture. Osteoporosis is correlated with a low Singh index value. The width of the femoral medial neck cortex is a reliable
predictor of hip fracture risk.
Keywords : Bone geometry, Osteoporosis, Hip fracture, Singh index, Hip axis length, Medial femoral neck width
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