title: Proximal femur geometry assessed by hip structural analysis in hip fracture in women.
abstract: BACKGROUND
  In the pathogenesis of hip fracture, proximal femur geometry plays a key role as well as decreased bone density. The hip structural analysis (HSA) processes dual energy X-ray absorptiometry (DXA) images containing information on the geometry closely related to the strength of the proximal femur. The objective of this study was to investigate bone mineral density (BMD) and mechanical properties of the proximal femur in a group of women with a previous contralateral hip fragility fracture compared to women without history of hip fracture.
  
  
  METHODS
  In a population of postmenopausal women, we evaluated bone density by DXA and bone geometry using the HSA parameters (femoral strength index, cross-sectional moment of inertia, cross-sectional area, section modulus, and buckling ratio) including hip axis length (HAL) and neck shaft angle.
  
  
  RESULTS
  Of a total of 62 postmenopausal women, twenty-six with a history of hip fracture had a mean femoral neck BMD significantly lower in comparison with 36 women in the control group (0.703 versus 0.768 g/cm(2), p = 0.0347). There was a statistically significant difference between groups also for HAL (106.75 mm in fracture group versus 100.93 mm in control group, p = 0.0015).
  
  
  CONCLUSIONS
  Our results demonstrated that all the geometrical parameters resulted worst into the group of patients with history of hip fracture, even though only the HAL was significantly lower in control subjects. In our opinion HSA is useful to characterize the risk of hip fracture in postmenopausal women, providing additional data on the spatial distribution of bone mass strongly related to bone strength.
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy. giovanni.iolascon@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Iolascon
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy.
authors.forename: Antimo
authors.initials: A
authors.lastname: Moretti
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cannaviello
authors.affiliation: Centre for the Study of Osteoporosis and Metabolic Bone Disease, Section of Orthopaedic and Traumatology, Treviglio-Caravaggio Hospital, Bergamo, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Resmini
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gimigliano
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D005272:Femur Neck / Q000473:pathology*; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D012306:Risk
keywords: Advanced hip assessment; Hip fracture; Hip geometry; Hip structural analysis; Osteoporosis