Retrospective Study
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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
Core Tip

Core Tip: The neck-shaft angle (NSA) and angle of the minimal resistance zone [the area located in Ward's triangle (AMRZ)] were most associated with femoral neck fracture risk, and a method for calculating the true value of these parameters and risk stratification was developed. Assessment of the geometric parameters of the femoral epiphysis revealed the greatest risk of a varus fracture of the neck if the AMRZ index > 24° and NSA < 127.5°. In contrast, the minimum risk was observed at AMRZ < 14° and NSA > 128.87°.