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. 2014 May;87(1037):20130358.
doi: 10.1259/bjr.20130358. Epub 2014 Feb 17.

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

C Ripamonti  1 , L Lisi, M Avella
Affiliations

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

C Ripamonti et al. Br J Radiol. 2014 May.

Abstract

Objective: To investigate the specificity of the neck shaft angle (NSA) to predict hip fracture in males.

Methods: We consecutively studied 228 males without fracture and 38 with hip fracture. A further 49 males with spine fracture were studied to evaluate the specificity of NSA for hip-fracture prediction. Femoral neck (FN) bone mineral density (FN-BMD), NSA, hip axis length and FN diameter (FND) were measured in each subject by dual X-ray absorptiometry. Between-mean differences in the studied variables were tested by the unpaired t-test. The ability of NSA to predict hip fracture was tested by logistic regression.

Results: Compared with controls, FN-BMD (p < 0.01) was significantly lower in both groups of males with fractures, whereas FND (p < 0.01) and NSA (p = 0.05) were higher only in the hip-fracture group. A significant inverse correlation (p < 0.01) was found between NSA and FN-BMD. By age-, height- and weight-corrected logistic regression, none of the tested geometric parameters, separately considered from FN-BMD, entered the best model to predict spine fracture, whereas NSA (p < 0.03) predicted hip fracture together with age (p < 0.001). When forced into the regression, FN-BMD (p < 0.001) became the only fracture predictor to enter the best model to predict both fracture types.

Conclusion: NSA is associated with hip-fracture risk in males but is not independent of FN-BMD.

Advances in knowledge: The lack of ability of NSA to predict hip fracture in males independent of FN-BMD should depend on its inverse correlation with FN-BMD by capturing, as the strongest fracture predictor, some of the effects of NSA on the hip fracture. Conversely, NSA in females does not correlate with FN-BMD but independently predicts hip fractures.

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