Shitova AD, Kovaleva ON, Olsufieva AV, Gadzhimuradova IA, Zubkov DD, Kniazev MO, Zharikova TS, Zharikov YO. Risk modeling of femoral neck fracture based on geometric parameters of the proximal epiphysis. World J Orthop 2022; 13(8): 733-743 [PMID: 36159625 DOI: 10.5312/wjo.v13.i8.733]
Corresponding Author of This Article
Yury O Zharikov, MD, PhD, MBA, Associate Professor, Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Mokhovaya Street 11, p. 10, Moscow 125009, Moscow, Russia. dr_zharikov@mail.ru
Research Domain of This Article
Anatomy & Morphology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2022; 13(8): 733-743 Published online Aug 18, 2022. doi: 10.5312/wjo.v13.i8.733
Risk modeling of femoral neck fracture based on geometric parameters of the proximal epiphysis
Anna D Shitova, Olga N Kovaleva, Anna V Olsufieva, Inchekhanum A Gadzhimuradova, Dmitry D Zubkov, Mikhail O Kniazev, Tatyana S Zharikova, Yury O Zharikov
Anna D Shitova, Inchekhanum A Gadzhimuradova, Dmitry D Zubkov, International School “Medicine of the Future”, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Moscow, Russia
Olga N Kovaleva, Tatyana S Zharikova, Yury O Zharikov, Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Moscow, Russia
Anna V Olsufieva, Department of Biomedical Disciplines of the Faculty of Medicine, Nonstate Educational Private Institution of Higher Education "Moscow Financial and Industrial University “Synergy”, Moscow 125190, Moscow, Russia
Mikhail O Kniazev, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Moscow, Russia
Author contributions: Shitova AD, Zubkov DD, Gadzhimuradova IA and Kniazev MO are responsible for measurement of bone parameters; Shitova AD, Olsufieva AV, Zubkov DD, Gadzhimuradova IA and Kniazev MO are responsible for data collection and analysis; Shitova AD, Olsufieva AV, Zubkov DD, Gadzhimuradova IA and Zharikova TS did the literature review; Shitova AD and Zubkov DD graphing in AutoCad2018; Zharikova TS created the figures; Kovaleva ON and Zharikov YO: project manager and scientific advisor.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the I.M. Sechenov First Moscow State Medical University (Sechenov University).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis of the X-ray images and anonymous clinical data that were obtained after each patient agreed to treatment by written consent. Cadaver material (70 femurs) was bequeathed to the Department of Human Anatomy by people and their relatives from 20 to 35 years ago, when these objects were designated for educational purposes for morphological departments.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yury O Zharikov, MD, PhD, MBA, Associate Professor, Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Mokhovaya Street 11, p. 10, Moscow 125009, Moscow, Russia. dr_zharikov@mail.ru
Received: September 23, 2021 Peer-review started: September 23, 2021 First decision: December 2, 2021 Revised: December 12, 2022 Accepted: July 26, 2022 Article in press: July 26, 2022 Published online: August 18, 2022 Processing time: 326 Days and 14.8 Hours
ARTICLE HIGHLIGHTS
Research background
Currently, a fracture of the femoral neck is a serious health problem, as it very often leads to long-term hospitalization, disability and death of patients. Modern medicine implies the prevention of such serious injuries and their consequences. At the moment, there are methods for assessing bone mineral density, but its geometry remains beyond attention.
Research motivation
This study was created for the reasons that existing methods often do not take into account the geometric parameters of the bone, and is aimed at filling this gap and creating techniques that complement existing ones.
Research objectives
The purpose of this work was to study the influence of bone geometry on its strength, as well as to find ways to apply these data in practice. The results of the study were conceived as an addition to the existing methods of assessing the risk of fracture.
Research methods
In our study, we measured 70 cadaveric bones and 20 X-rays by creating digital copies of them and processing them in the AutoCAD environment. The cuts of the proximal epiphyses of bones were studied. An analysis was also carried out aimed at identifying parameters correlating with a high risk of fracture. A scale was created as a possible risk assessment tool.
Research results
In our research, we studied the course of bone beams, the distribution of bone tissue in the proximal epiphysis and found the zone that is most vulnerable to mechanical stress. The parameters of the proximal epiphysis were investigated and those that may indicate a higher risk of fracture were identified. A scale was proposed and tested to assess this risk.
Research conclusions
The geometric parameters of the bone reflect the features of the structure of the bone beams and the distribution of bone matter. There are parameters of the proximal epiphysis, the measurement of which with the help of modern imaging methods can help determine the increased risk of fracture of the proximal epiphysis of the femur. Modern methods of risk stratification often ignore the geometric parameters of the bone and our study suggests a way to take them into account to determine the risks of fracture.
Research perspectives
In order to develop the idea, it is possible to conduct a larger-scale study with a large number of participants. Further refinement of the scale is needed in order to clarify it and possibly expand it. With satisfactory results of refinement, it is possible to introduce the proposed methodology into practice for its clinical trial.
