Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 8/2010

01.08.2010 | Clinical Research

Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck

verfasst von: A. Frost, MRCS, G. Pavlou, MRCS, P. J. Richards, FRCR, J. Belcher, BSc MPhil PhD, V. Jasani, FRCS

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 8/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Fractures through the proximal femur are broadly grouped into intertrochanteric fractures and intracapsular fractures. It is not clear why a patient may sustain an intertrochanteric fracture as compared with an intracapsular fracture. There is an established relationship between relative hip retroversion and the development of osteoarthritis. We postulate retroversion also may be a risk factor for having intracapsular fractures develop.

Questions/purposes

We looked specifically at the geometry of the hip to analyze the possibility of a relationship between acetabular version, femoral version, and Mckibbin’s instability index and fracture type.

Patients and Methods

We recruited 40 patients with fractures of the femoral neck for the study. There were 15 men and 25 women with a mean age of 80 years (range, 57–92 years). There were 14 intertrochanteric fractures and 26 intracapsular fractures. After treating their fracture, the contralateral hip was scanned in a CT scanner and assessed by two independent observers to establish the acetabular and femoral version.

Results

We found no correlation between proximal femoral fracture type and the contralateral femoral version, femoral neck length, acetabular version, or Mckibbin’s instability index or between fracture type and age or gender.

Conclusions

There appears to be no correlation between proximal femoral fracture type and acetabular or femoral version.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Binns M, Shardlow D, Soames R. Proximal femoral fracture: range of hip motion as a predictor of fracture type. Clin Orthop Relat Res. 2000;376:222–228.CrossRefPubMed Binns M, Shardlow D, Soames R. Proximal femoral fracture: range of hip motion as a predictor of fracture type. Clin Orthop Relat Res. 2000;376:222–228.CrossRefPubMed
3.
Zurück zum Zitat Center JR, Nguyen TV, Pocock NA, Noakes KA, Kelly PJ, Eisman JA, Sambrook PN. Femoral neck axis length, height loss and risk of hip fracture in males and females. Osteoporosis Int. 1998;8:75–81.CrossRef Center JR, Nguyen TV, Pocock NA, Noakes KA, Kelly PJ, Eisman JA, Sambrook PN. Femoral neck axis length, height loss and risk of hip fracture in males and females. Osteoporosis Int. 1998;8:75–81.CrossRef
4.
Zurück zum Zitat Ecker ML, Joyce JJ III, Kohl EJ. The treatment of trochanteric hip fractures using a compression screw. J Bone Joint Surg Am. 1975;57:23–27.PubMed Ecker ML, Joyce JJ III, Kohl EJ. The treatment of trochanteric hip fractures using a compression screw. J Bone Joint Surg Am. 1975;57:23–27.PubMed
5.
Zurück zum Zitat Ezoe M, Naito M, Inoue T. The prevalence of acetabular retroversion among various disorders of the hip. J Bone Joint Surg Am 2006; 88: 372–379.CrossRefPubMed Ezoe M, Naito M, Inoue T. The prevalence of acetabular retroversion among various disorders of the hip. J Bone Joint Surg Am 2006; 88: 372–379.CrossRefPubMed
6.
Zurück zum Zitat Faulkner KG, Cummings SR, Black D, Palermo L, Glüer CC, Genant HK. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Miner Res. 1993;8:1211–1217.CrossRefPubMed Faulkner KG, Cummings SR, Black D, Palermo L, Glüer CC, Genant HK. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Miner Res. 1993;8:1211–1217.CrossRefPubMed
7.
Zurück zum Zitat Ferris BB, Dodds RA, Klenerman L, Bitensky L, Chayen J. Major components of bone in subcapital and trochanteric fractures: a comparative study. J Bone Joint Surg Br. 1987;69:234–237.PubMed Ferris BB, Dodds RA, Klenerman L, Bitensky L, Chayen J. Major components of bone in subcapital and trochanteric fractures: a comparative study. J Bone Joint Surg Br. 1987;69:234–237.PubMed
8.
Zurück zum Zitat Ferris BD, Kennedy C, Bhamra M, Muirhead-Allwood W. Morphology of the femur in proximal femoral fractures. J Bone Joint Surg Br. 1989;71:475–477.PubMed Ferris BD, Kennedy C, Bhamra M, Muirhead-Allwood W. Morphology of the femur in proximal femoral fractures. J Bone Joint Surg Br. 1989;71:475–477.PubMed
9.
Zurück zum Zitat Fox KM, Cummings SR, Williams E, Stone K; Study of Osteoporotic Fractures. Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporosis Int. 2000;11:1018–1023.CrossRef Fox KM, Cummings SR, Williams E, Stone K; Study of Osteoporotic Fractures. Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporosis Int. 2000;11:1018–1023.CrossRef
10.
Zurück zum Zitat Gelberman RH, Cohen MS, Shaw BA, Kasser JR, Griffin PP, Wilkinson RH. The association of femoral retroversion with slipped capital femoral epiphysis. J Bone Joint Surg Am. 1986;68:1000–1007.PubMed Gelberman RH, Cohen MS, Shaw BA, Kasser JR, Griffin PP, Wilkinson RH. The association of femoral retroversion with slipped capital femoral epiphysis. J Bone Joint Surg Am. 1986;68:1000–1007.PubMed
11.
Zurück zum Zitat Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:263–269.PubMed Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:263–269.PubMed
12.
Zurück zum Zitat Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC. Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res. 1994;9:1889–1894.CrossRefPubMed Greenspan SL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC. Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res. 1994;9:1889–1894.CrossRefPubMed
13.
Zurück zum Zitat Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporosis Int. 1997;7:407–413.CrossRef Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporosis Int. 1997;7:407–413.CrossRef
14.
Zurück zum Zitat Hinton RY, Smith GS. The association of age, race, and sex with the location of proximal femoral fractures in the elderly. J Bone Joint Surg Am. 1993;75:752–759.PubMed Hinton RY, Smith GS. The association of age, race, and sex with the location of proximal femoral fractures in the elderly. J Bone Joint Surg Am. 1993;75:752–759.PubMed
15.
Zurück zum Zitat Kim WY, Hutchinson CE, Andrew JG, Allen PD. The relationship between acetabular retroversion and osteoarthritis of the hip. J Bone Joint Surg Br. 2006;88:727–729.CrossRefPubMed Kim WY, Hutchinson CE, Andrew JG, Allen PD. The relationship between acetabular retroversion and osteoarthritis of the hip. J Bone Joint Surg Br. 2006;88:727–729.CrossRefPubMed
16.
Zurück zum Zitat Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck: a meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994;76:15–25.PubMed Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck: a meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994;76:15–25.PubMed
17.
Zurück zum Zitat Mckibbin B. Anatomical factors in the stability of the hip joint in the newborn. J Bone Joint Surg Br. 1970;52:148–159.PubMed Mckibbin B. Anatomical factors in the stability of the hip joint in the newborn. J Bone Joint Surg Br. 1970;52:148–159.PubMed
18.
Zurück zum Zitat Michelotti J, Clark J. Femoral neck length and hip fracture risk. J Bone Miner Res. 1999;14:1714–1720.CrossRefPubMed Michelotti J, Clark J. Femoral neck length and hip fracture risk. J Bone Miner Res. 1999;14:1714–1720.CrossRefPubMed
19.
Zurück zum Zitat Morvan G, Testard S, Busson J, Cartier S. [Computed tomographic measurement of the angle of torsion of the femoral neck: experimental reliability study on dry bone] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1987;73:511–516.PubMed Morvan G, Testard S, Busson J, Cartier S. [Computed tomographic measurement of the angle of torsion of the femoral neck: experimental reliability study on dry bone] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1987;73:511–516.PubMed
20.
Zurück zum Zitat Parker MJ, Pryor GA, Anand JK, Lodwick R, Myles JW. A comparison of presenting characteristics of patients with intracapsular and extracapsular proximal femoral fractures. J R Soc Med. 1992;85:152–155.PubMed Parker MJ, Pryor GA, Anand JK, Lodwick R, Myles JW. A comparison of presenting characteristics of patients with intracapsular and extracapsular proximal femoral fractures. J R Soc Med. 1992;85:152–155.PubMed
21.
Zurück zum Zitat Patton MS, Duthie RA, Sutherland AG. Proximal femoral geometry and hip fractures. Acta Orthop Belg. 2006;72:51–54. Patton MS, Duthie RA, Sutherland AG. Proximal femoral geometry and hip fractures. Acta Orthop Belg. 2006;72:51–54.
22.
Zurück zum Zitat Rao JP, Banzon MT, Weiss AB, Rayhack J. Treatment of unstable intertrochanteric fractures with anatomic reduction and compression hip screw fixation. Clin Orthop Relat Res. 1983;175:65–71.PubMed Rao JP, Banzon MT, Weiss AB, Rayhack J. Treatment of unstable intertrochanteric fractures with anatomic reduction and compression hip screw fixation. Clin Orthop Relat Res. 1983;175:65–71.PubMed
23.
Zurück zum Zitat Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.CrossRefPubMed Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.CrossRefPubMed
24.
Zurück zum Zitat Rogmark C, Carlsson A, Johnell O, Sernbo I. A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur: functional outcome for 450 patients at two years. J Bone Joint Surg Br. 2002;84:183–188.CrossRefPubMed Rogmark C, Carlsson A, Johnell O, Sernbo I. A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur: functional outcome for 450 patients at two years. J Bone Joint Surg Br. 2002;84:183–188.CrossRefPubMed
25.
Zurück zum Zitat Rosenbaum TG, Hamblin T, Bloebaum RD. Determining the degree of cortical bone asymmetry in bilateral, nonpathological, human femur pairs. J Biomed Mater Res A. 2006;76:450–455.PubMed Rosenbaum TG, Hamblin T, Bloebaum RD. Determining the degree of cortical bone asymmetry in bilateral, nonpathological, human femur pairs. J Biomed Mater Res A. 2006;76:450–455.PubMed
26.
Zurück zum Zitat Sugano N, Noble PC, Kamaric E. A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr. 1998;22:610–614.CrossRefPubMed Sugano N, Noble PC, Kamaric E. A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr. 1998;22:610–614.CrossRefPubMed
27.
Zurück zum Zitat Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81:1747–1770.PubMed Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81:1747–1770.PubMed
Metadaten
Titel
Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck
verfasst von
A. Frost, MRCS
G. Pavlou, MRCS
P. J. Richards, FRCR
J. Belcher, BSc MPhil PhD
V. Jasani, FRCS
Publikationsdatum
01.08.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 8/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1185-z

Weitere Artikel der Ausgabe 8/2010

Clinical Orthopaedics and Related Research® 8/2010 Zur Ausgabe

Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society

Synovial Fluid Biomarkers for Periprosthetic Infection

Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society

Irrigation and Débridement and Prosthesis Retention for Treating Acute Periprosthetic Infections

Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society

Strength of Antimicrobial Bone Cement Decreases with Increased Poragen Fraction

Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society

Revision Hip Arthroplasty: Infection is the Most Common Cause of Failure

Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society

Prior Use of Antimicrobial Therapy is a Risk Factor for Culture-negative Prosthetic Joint Infection

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.