Adult ; Bone Neoplasms ; pathology ; surgery ; Femur Neck ; pathology ; Humans ; Male ; Osteochondroma ; pathology ; surgery

Hip fractures have high morbidity and mortality rate for the people as a complication of osteoporosis and is generally seen in old age. It is known that femoral geometric measurements are important in the assessment of hip fracture risks. This study aimed to examine the association between hip geometry and hip fracture in post-menopausal elderly females. In the present study, 232 hip X-rays were taken from women with no hip fractures (Group 1) and 29 post-menopausal women with hip fractures (Group 2) after a minor trauma. After standard anterior-posterior plain pelvic X-ray radiographs were obtained, various radiographic measurements were performed in all cases, including the hip axis length (HAL), femoral neck axis length (FAL), acetabular width (AW), femoral head width (HW), femoral neck width (FW), femoral shaft width (FSW), intertrochanteric width (TW), lateral and medial cortical thickness of the femoral shaft (LCT, SMCT), femoral neck cortical thickness (NMCT) and femoral neck-shaft angle (Q-angle). In group 1, the mean age, weight and height were 62.5 +/-7.4 years, 70.8 +/-12.5 kg, and 157.5 +/-6.7 cm, respectively. In group 2, these values were 70.17 +/-6.8 years, 64.7 +/-11.5 kg, and 158.3 +/-2.7 cm, respectively. There were no statistically significant differences in the measurements of HAL, FAL, AW and HW between the two groups. In group 2, the mean FW value was significantly higher than in group 1 (p= 0.01). The mean values for FSW, TW, NMCT, SMCT, LCT were statistically lower in group 2 than those in group 1 (p= 0.01, p=0.038, p=0.001, p< 0.001, p< 0.001, respectively). Q-angle was also significantly higher in cases with hip fracture than in cases with no hip fracture (p=0.01). The values of FW, FSW, TW, NMCT, SMCT, LCT and Q-angle seem to be important parameters in the evaluation of hip fracture risks. However, further studies are needed to clarify this conclusion.
Aged ; Body Mass Index ; Female ; Femur/*anatomy & histology ; Femur Neck/anatomy & histology ; Hip Fractures/*pathology ; Humans ; Middle Aged

OBJECTIVETo observe the changes of proximal femoral geometry after femoral neck fracture treated with THA, analyze the existent of differences and their manifestation.

METHODSAll patients of femoral neck fracture (FNF) and osteonecrosis of femoral head (ONFH) were treated with THA by the same operating team from January to December of 2014, including 22 patients with FNF (11 males and 11 females,with age from 44 to 83 years old (means 66.18 ± 11.47) and 23 patients with ONFH (12 males and 11 females, with age from 19 to 68 years old (means 51.91 ± 11.76). After THA, height of femorals, offsets, osteotomy position and adjusting modes were measured and the statistic analysis was done.

RESULTSAfter THA, all patients were measured. Decreased femoral height, offsets and lower osteotomy positions were found in patients with FNF than those with ONFH, and 3 kinds of adjustments because of lower-positional osteotomy were found.

CONCLUSIONAfter THA, lower-positional osteotomy and decreased femoral offsets may occur on patients with FNF. The adjustments caused by lower-positional osteotomy may lead to negative results.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; pathology ; surgery ; Femur ; pathology ; Femur Head Necrosis ; pathology ; surgery ; Humans ; Male ; Middle Aged

POEMS syndrome is a multisystem disorder associated with polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein (M-protein), and skin changes. The authors describe a patient with POEMS syndrome who had osteosclerotic myeloma confirmed by open bone biopsy. Magnetic resonance imaging (MRI) showed discrete lesions of low signal intensity in both T1 and T2-weighted images. This patient is now being successfully treated with melphalan and prednisone with much improvement in skin thickening and sensory change in the lower extremities.
Adult ; Biopsy ; Femur Neck/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Multiple Myeloma/complications/pathology ; POEMS Syndrome/complications/*diagnosis

BACKGROUNDThe accurate measurement of the femoral anteversion (FA) angle is always a topic of much debate in the orthopedic surgery and radiology research. We aimed to explore a new FA measurement method to acquire accurate results without radiation damage using piglet model.

METHODSA total of thirty piglets were assigned to two groups based on the age. Bilateral femora were imaged with 3.0-T magnetic resonance (MR) and 64-slice computed tomography (CT) examinations on all piglets. FA was measured on MR-three-dimensional (3D) postprocessing software with a four-step method: initial validation of the femoral condylar axis, validation of the condylar plane, validation of the femoral neck axis, and line-plane angle measurement of FA. After MR and CT examinations, all piglets were sacrificed and their degree of FA was measured using their excised, dried femora. MR, CT, and dried-femur measurement results were analyzed statistically; MR and CT measurements were compared for accuracy against each other and against the gold standard dried femur measurement.

RESULTSIn both groups, the mean FA value measured by MR was lower than that measured by CT. A statistically significant difference was observed between CT- and dried-femur measurements but not between MR- and dried-femur measurements. A higher correlation (0.783 vs. 0.408) and a higher consistency (0.863 vs. 0.578) with dried-femur measurement results were seen for MR measurements than CT measurements in the 1-week age group. However, in the 8-week age group, similar correlations (0.707 vs. 0.669) and consistencies (0.864 vs. 0.821) were observed.

CONCLUSIONSNoninvasive MR-3D-Cube reconstruction was able to accurately measure FA in piglets. Particularly in the 1-week age group with a larger proportion of cartilaginous structures, the correlation and consistency between MR- and dried-femur measurement results were higher than those between CT- and dried-femur measurements, suggesting that MR may be a new useful examination tool for FA-related diseases in children.

Animals ; Bone Anteversion ; diagnosis ; Femur Neck ; pathology ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; methods ; Swine ; Tomography, X-Ray Computed

OBJECTIVETo observe the distribution law and study the factors related to the femoral neck anteversion angle among the patients with developmental dysplasia of the hip of Hartofilakidis type I.

METHODSAmong the patients with hip dysplasia of Hartofilakidis type I who was admitted to Department of Orthopaedic Surgery, the First Affiliated Hospital of People's Liberation Army General Hospital from June 2010 to June 2013, a total of 340 hips (25 male and 161 female) were included in the study. The average age was 28.3 years, ranging from 13.5 to 49.9 years. The observation index included: femoral neck anteversion angle, lateral center-edge angle, acetabular index angle, lateral displacement of the femoral head, superior displacement of the femoral head, continuity of Shenton's line and Calve's line. The correlation between different factors was analyzed, and the factor closest to femoral neck anteversion angle was analyzed further by regression analysis.

RESULTSAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the femoral neck anteversion angle increased, with an average of 28°±13°. Correlation and regression analysis showed significant negative correlation with treatment age (r=-0.158, P=0.003; t=-6.892, P=0.000); positive correlation with gender (r=0.332, P=0.000; t=-4.376, P=0.000); significant positive correlation with lateral displacement of the femoral head (r=0.092, P=0.000; t=3.766, P=0.000); significant negative correlation with central-edge angle (r=-0.122, P=0.024; t=2.031, P=0.043). The femoral neck anteversion angle showed correlation with acetabular index angle, continuity of Calve's line and superior displacement of the femoral head in correlation analysis, not in regression analysis, however, it did not show correlation with side and continuity of Shenton's line.

CONCLUSIONAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the increasing of the femoral neck anteversion angle may not only lead to early onset and therefore early treatment of pain in the hip joint but also the lateral displacement of the femoral head that requires immediate medical attention.

Acetabulum ; Adolescent ; Adult ; Female ; Femur Head ; Femur Neck ; pathology ; Hip Dislocation, Congenital ; pathology ; surgery ; Hip Joint ; Humans ; Hyperplasia ; Male ; Middle Aged ; Orthopedic Procedures ; Orthopedics ; Regression Analysis ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo discuss the imaging manifestation and clinical value in herniation pit of femoral neck.

METHODSOne case proved by operation and pathology and twenty cases with typical imaging manifestation described by Pitt were reviewed retrospectively. There were 17 males and 4 females with an average age of 53 years old(ranging from 30 to 85 years). All cases were examined by X-ray films and CT, and 13 cases were performed with MRI.

RESULTSTwenty-nine lesions were found in the 21 cases, 9 cases were in right side, 8 cases were in left side, 4 cases were in both sides. The lesions were all located in the superior lateral part of the femoral neck and anterior lateral base of femoral head. The lesions were round or oval, and most of their greatest diameter was less than 16 mm. X-ray films showed a central radiolucency with a thin clear sclerotic rim or simple sclerotic loop. CT scans showed a well-defined lesion of soft-tissue attenuation with sclerotic margin. The lesions had focal cortical perforation. On MRI images,most lesions showed uniformly long T1 and long T2 fluid signal intensity.

CONCLUSIONHerniation pit of femoral neck have some specific imaging features, CT can make accurate diagnosis. X-ray and MRI are helpful to diagnosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Femur Neck ; diagnostic imaging ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

Osteopontin (OPN) is an acidic, noncollagenous matrix protein produced by the bone and kidneys. It is reportedly involved in bone resorption and formation. We examined the association between serum OPN levels and bone mineral density in postmenopausal women. Premenopausal women (n=32) and postmenopausal women (n=409) participated in the study. We measured serum osteopontin levels and their relationships with bone mineral density and previous total fragility fractures. The postmenopausal women had higher mean serum OPN levels compared to the premenopausal women (43.6+/-25.9 vs 26.3+/-18.6 ng/mL; P<0.001). In the postmenopausal women, high serum OPN levels were negatively correlated with mean lumbar bone mineral density (BMD) (r=-0.113, P=0.023). In a stepwise multiple linear regression model, serum OPN levels were associated with BMD of the spine, femoral neck, and total hip after adjustment for age, body mass index, smoking, and physical activity in postmenopausal women. However, serum OPN levels did not differ between postmenopausal women with and without fractures. Postmenopausal women exhibit higher serum OPN levels than premenopausal women and higher serum OPN levels were associated with low BMD in postmenopausal women.
Aged ; Bone Density/*physiology ; Female ; Femur Neck/metabolism ; Fractures, Bone/metabolism/pathology ; Humans ; Linear Models ; Middle Aged ; Osteopontin/*blood ; Postmenopause ; Premenopause ; Spine/metabolism

BACKGROUNDA number of studies have examined the association between estrogen receptor alpha (ESR-α) gene polymorphisms and bone mineral density (BMD), but previous studies of ESR-α gene XbaI (rs9340799) and PvuII (rs2234693) polymorphisms have been hampered by small sample size, regional restrictions and inconclusive results. Thus a meta-analysis is needed to assess their pooled effects.

METHODSThis study reviewed all published articles indexed in Pubmed using the keywords in the title or abstract. All data were extracted independently by two reviewers using a standard form, the studies were meta-analyzed and minor discrepancies were resolved by authors' discussion.

RESULTSTwenty seven eligible studies involving 8467 women and 2032 men were identified. The XbaI and PvuII polymorphisms were significantly associated with BMD of the lumbar spine. XX and PP homozygotes had a protective effect in comparison with carriers of the x and p alleles, the effects were more significant in premenopausal women or Western women. At the femoral neck, the results were different. XX served as a protective factor in postmenopausal women, Western women, Western postmenopausal women, and men, while PP was likely to serve as a risk factor in Eastern women, Eastern postmenopausal women, and men.

CONCLUSIONSThe XbaI polymorphism is correlated to BMD at diverse skeletal sites. PP had a protective role for the lumbar spine but might be a risk factor for the femoral neck.

Bone Density ; genetics ; Estrogen Receptor alpha ; genetics ; Female ; Femur Neck ; pathology ; Gene Frequency ; Genetic Predisposition to Disease ; Humans ; Male ; Osteoporosis, Postmenopausal ; genetics ; Polymorphism, Genetic ; genetics

Adolescent ; Bone Nails ; adverse effects ; Femoral Fractures ; surgery ; Femoral Neck Fractures ; etiology ; Femur Neck ; pathology ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; Fractures, Spontaneous ; etiology ; surgery ; Humans ; Male ; Postoperative Complications ; Reoperation