Hip geometry and femoral neck fractures: A meta-analysis

BACKGROUND: Several studies have reported hip geometry to predict the femoral neck fractures. However, they showed inconsistency. OBJECTIVES: To determine the association between hip geometry and femoral neck fractures. METHODS: Published literature from PubMed and Embase databases (until May 25(th), 2017) was searched for eligible publications. The information related to (1) name of first author; (2) year of publication; (3) country of origin; (4) sample size of cases and controls and (5) mean and standard deviation of cases and controls were extracted. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between hip geometry and femoral neck fractures were assessed using random or fixed effect model. A Comprehensive Meta-analysis software, version 2.0, was used to analyse the data. RESULTS: A total of 11 studies were included in this study. Our results showed that increase in hip axis length (OR 95% CI = 1.53 [1.06–2.21], p = 0.025), femoral neck angle (OR 95% CI = 1.47 [1.01–2.15], p = 0.044) and neck width (OR 95% CI = 2.68 [1.84–3.91], p < 0.001) was associated with the risk of femoral neck fractures, whereas we could not find the correlation between femoral neck axis length and the risk of femoral neck fractures. CONCLUSION: There is strong evidence that elevated hip axis length, femoral neck angle and neck width are the risk factor for femoral neck fractures. The Translational Potential of this Article: Determining the hip axis length, femoral neck angle and neck width that are most highly associated with femoral neck fracture may allow clinicians to more accurately predict which individuals are likely to experience femoral neck fractures in the future.