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Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern

Introduction: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain...

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Autores principales: Ellanti, Prasad, Mohan, Kunal, Moriarity, Andrew, Hogan, Niall, McCarthy, Tom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680670/
https://www.ncbi.nlm.nih.gov/pubmed/29125120
http://dx.doi.org/10.1051/sicotj/2017051
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author Ellanti, Prasad
Mohan, Kunal
Moriarity, Andrew
Hogan, Niall
McCarthy, Tom
author_facet Ellanti, Prasad
Mohan, Kunal
Moriarity, Andrew
Hogan, Niall
McCarthy, Tom
author_sort Ellanti, Prasad
collection PubMed
description Introduction: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain radiographs has been suggested to be a method for indicating osteoporosis and as a risk factor of hip fractures in the elderly. Methods: A retrospective study was undertaken to assess the usefulness of the canal-diaphysis ratio (CDR) as a risk factor for developing a hip fracture, excluding patients presenting under 50 years old, following high-energy trauma or pathological fractures. The CDR was measured in 84 neck of femur (NOF) fracture patients and 84 intertrochanteric hip fracture patients, and these were subsequently compared to the CDR of 84 patients without a hip fracture. Measurements were taken on two occasions by two members of the orthopaedic team, so as to assess the test’s inter- and intraobserver reliability. Results: In comparison to those without a fracture, there was a significant difference in the CDR of patients with a NOF fracture (P < 0.0001) and intertrochanteric fracture (P < 0.0001). Furthermore, the odds of having a CDR above 60.67 and 64.41 were significantly higher in the NOF (OR = 2.214, P = 0.0129) and intertrochanteric fracture (OR = 32.27, P < 0.0001) groups respectively, when compared to the non-fractured group. The analysis of the test’s inter- and intraobserver reliability showed strong levels of reproducibility. Discussion: We concluded that a raised CDR was associated with an increased incidence of NOF and intertrochanteric hip fracture. Measuring the CDR can thus be considered as a reproducible and inexpensive method of identifying elderly patients at risk of hip fractures.
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spelling pubmed-56806702017-11-28 Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern Ellanti, Prasad Mohan, Kunal Moriarity, Andrew Hogan, Niall McCarthy, Tom SICOT J Research Introduction: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain radiographs has been suggested to be a method for indicating osteoporosis and as a risk factor of hip fractures in the elderly. Methods: A retrospective study was undertaken to assess the usefulness of the canal-diaphysis ratio (CDR) as a risk factor for developing a hip fracture, excluding patients presenting under 50 years old, following high-energy trauma or pathological fractures. The CDR was measured in 84 neck of femur (NOF) fracture patients and 84 intertrochanteric hip fracture patients, and these were subsequently compared to the CDR of 84 patients without a hip fracture. Measurements were taken on two occasions by two members of the orthopaedic team, so as to assess the test’s inter- and intraobserver reliability. Results: In comparison to those without a fracture, there was a significant difference in the CDR of patients with a NOF fracture (P < 0.0001) and intertrochanteric fracture (P < 0.0001). Furthermore, the odds of having a CDR above 60.67 and 64.41 were significantly higher in the NOF (OR = 2.214, P = 0.0129) and intertrochanteric fracture (OR = 32.27, P < 0.0001) groups respectively, when compared to the non-fractured group. The analysis of the test’s inter- and intraobserver reliability showed strong levels of reproducibility. Discussion: We concluded that a raised CDR was associated with an increased incidence of NOF and intertrochanteric hip fracture. Measuring the CDR can thus be considered as a reproducible and inexpensive method of identifying elderly patients at risk of hip fractures. EDP Sciences 2017-11-10 /pmc/articles/PMC5680670/ /pubmed/29125120 http://dx.doi.org/10.1051/sicotj/2017051 Text en © The Authors, published by EDP Sciences, 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Ellanti, Prasad
Mohan, Kunal
Moriarity, Andrew
Hogan, Niall
McCarthy, Tom
Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title_full Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title_fullStr Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title_full_unstemmed Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title_short Canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
title_sort canal to diaphysis ratio as a risk factor for hip fractures and hip fracture pattern
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680670/
https://www.ncbi.nlm.nih.gov/pubmed/29125120
http://dx.doi.org/10.1051/sicotj/2017051
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