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Intra-Individual Differences of the Femoral Cortical Thickness Index in Elderly Patients with a Proximal Femoral Fracture

Title: Intra-Individual Differences of the Femoral Cortical Thickness Index in Elderly Patients with a Proximal Femoral Fracture
Authors: Flurina Guyan; Manuel Waltenspül; Michael Dietrich; Method Kabelitz
Source: Journal of Clinical Medicine ; Volume 14 ; Issue 8 ; Pages: 2654
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: cortical thickness index; osteoporosis; proximal femoral fracture; geriatric
Description: Background/Objectives: Osteoporosis is prevalent in the elderly and increases fracture risk. Bone density is commonly assessed using dual-energy X-ray absorptiometry (DEXA). The femoral cortical thickness index (CTI) also provides indirect information for osteoporosis. It remains unclear whether there are intra-individual differences and if a correlation to fracture risk of the CTI in fractured femora results due to fracture related malrotation during X-rays. The aim of this study was to investigate the individual bilateral CTI in patients with proximal femoral fractures. Methods: A retrospective analysis of 200 surgically treated patients (100 trochanteric, 100 femoral neck fractures) was performed. Measurements included the bilateral CTI at 10 and 15 cm below the lesser trochanter. Analysis of the correlation of those examinations, in comparison to the contralateral CTI at 15 cm, and correlation of the CTI with the body mass index (BMI) and age was performed. Results: Results showed significant differences (p < 0.001) in bilateral CTIs for both fracture types at 15 cm with a strong inter-rater reliability (ICC > 0.9). There was no significant correlation between age and CTI, as well as BMI and CTI in both cohorts (p > 0.1). Sex-specific subgroup analyses revealed that females exhibited significant differences in CTI between fractured and non-fractured sides (p < 0.001). Conclusions: In conclusion, CTI, and the modified CTI at 15 cm below the lesser trochanter in fractured proximal femora, is lower compared to the non-fractured side. The femoral CTI could help in daily clinical routines and circumstances, where more detailed risk prediction tools are lacking.
Document Type: text
File Description: application/pdf
Language: English
Relation: Orthopedics; https://dx.doi.org/10.3390/jcm14082654
DOI: 10.3390/jcm14082654
Availability: https://doi.org/10.3390/jcm14082654
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.9F8A6F56
Database: BASE