Background: Intertrochanteric fracture of femur is one of the commonest injuries comprise approximately half of all hip fractures caused by low energy trauma in elderly population and 20% of the operative workload of an orthopedic trauma. There is increasing evidence that the proximal femoral geometry has an important role in the etiology of hip fractures. We performed a simple radiological study to investigate the relationship of proximal femoral geometry between Femoral neck (NOF) and Intertrochanteric (IT) fractures.
Methods: A Prospective Radiographic Observational hospital based clinical study was conducted at Department of Orthopedic Surgery, Lumbini Provincial Hospital, National Trauma Center, Bharatpur Hospital and Civil Service Hospital from January 2021 to July 2022. A total of 120 patients, 60 sustaining Femoral Neck fracture and 60 sustaining Intertrochanteric fracture were enrolled. Proximal femoral geometry (HAL, FNL and NSA) was measured from the contralateral normal hip in the X-ray Anteroposterior view of pelvis. The data were recorded and Student’s t test was used to compare the continuous variables.
Results: Statistically significant difference in HAL was found between NOF and IT fractures in age group 51-60 years (11.64 ± 0.05cms vs 11.04+/-0.65cms, p 0.025). However, no statistical difference was found in FNL (2.62+/-0.29cms vs 2.69+/-0.34, p 0.224) and NSA (129.71+/-3.56 degrees vs 129.77+/-3.67 degrees, p 0.92) between two groups.
Conclusion: HAL was found to be increased in group sustaining femoral neck fracture as compared to group with Intertrochanteric fracture, especially in age group 51-60 years. We didn’t find any statistical difference in FNL and NSA among these two fracture group. As most of the literature has also stated, we conclude that HAL is an independent predictor of risk of hip fracture and that the patients with increased HAL are more prone to femoral neck fracture. It can be used as a screening tool in patients to predict and thereby forewarn about their susceptibility to hip fracture.