Oulianski Maria, Sagi Amit, Rosinsky Philip, Bilenko Garrik, Avraham Dana, Lubovsky Omri
Orthopedic Department, Kaplan Medical Center, Rehovot 7639302, Israel.
Orthopedic Department, Barzilai Medical Center, Ashkelon 7810000, Israel.
J Clin Med. 2025 Apr 17;14(8):2768. doi: 10.3390/jcm14082768.
: Proximal femur fractures are common in the older population and are related to bone quality. Our work evaluates bone parameters from pelvic anteroposterior (AP) radiographs in patients with trochanteric and sub-capital fractures to determine if there are predictive morphology parameters for each fracture type. : Data from 237 medical records were extracted from patients who arrived at our hospital with trochanteric and sub-capital femoral fractures. Descriptive data and radiological evaluation of the calcar-to-canal ratio (CCR), cortical thickness index (CTI), and Dorr classification were measured by two observers and statistically evaluated. : A total of 202 patients were found to be eligible for the study. The mean patient age was 81.41 ± 7.27 years old. The mean age of the trochanteric group was significantly higher than that of the sub-capital group ( = 0.005). There were no statistically significant differences in gender and comorbidities. The CCR showed significance, but the CTI and Dorr classification did not show a significant difference ( = 0.001, = 0.78, and = 0.98). A high degree of reliability was shown for all measurements. The ICC for CTI and CCR was = 0.791 and = 0.770 ( < 0.001), and Cronbach's alpha was 0.815 and 0.796, respectively. Logistic regression was found to be significant in predicting 60.4% of correct forecasts with an odds ratio of 0.011 and 95% confidence interval ( = 0.001). For CTI, the correct forecasting rate was 48%, with an odds ratio of 0.615 ( = 0.78). : We found that, out of the measured parameters, the CCR stood out as important, showing that higher CCR levels are linked to an increased likelihood of trochanteric fractures.
股骨近端骨折在老年人群中很常见，且与骨质有关。我们的研究评估了转子间骨折和股骨头下骨折患者骨盆前后位（AP）X线片的骨参数，以确定每种骨折类型是否存在预测性形态学参数。：从我院收治的转子间和股骨头下股骨骨折患者的237份病历中提取数据。由两名观察者测量粗隆至髓腔比率（CCR）、皮质厚度指数（CTI）和Dorr分类的描述性数据及影像学评估，并进行统计学分析。：共发现202例患者符合研究条件。患者平均年龄为81.41±7.27岁。转子间组的平均年龄显著高于股骨头下组（P = 0.005）。性别和合并症方面无统计学显著差异。CCR显示出显著性，但CTI和Dorr分类未显示出显著差异（P = 0.001、P = 0.78和P = 0.98）。所有测量均显示出高度可靠性。CTI和CCR的组内相关系数（ICC）分别为0.791和0.770（P < 0.001），Cronbach's α系数分别为0.815和0.796。逻辑回归在预测正确结果方面具有显著性，预测正确率为60.4%，优势比为0.011，95%置信区间（P = 0.001）。对于CTI，正确预测率为48%，优势比为0.615（P = 0.78）。：我们发现在所测量的参数中，CCR最为重要，表明较高的CCR水平与转子间骨折可能性增加有关。
