Acetabular morphological variation in Asian patients with femoral neck fracture: A three-dimensional CT-based study

• Published in: Injury 2022-08, Vol.53 (8), p.2823-2831
• Main Authors: Sano, Kei, Homma, Yasuhiro, Shirogane, Yuichi, Ishii, Seiya, Ito, Tomoyuki, Baba, Tomonori, Kaneko, Kazuo, Ishijima, Muneaki
• Format: Article
• Language: English
• Subjects: Acetabular morphological variant; Acetabulum - anatomy & histology; Acetabulum - diagnostic imaging; Acetabulum - surgery; Aged; Asian; Developmental dysplasia of the hip; Female; Femoral neck fracture; Femoral Neck Fractures - diagnostic imaging; Femoral Neck Fractures - surgery; Hip Dislocation - diagnostic imaging; Hip Dislocation - surgery; Hip Dislocation, Congenital - surgery; Humans; Male; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2022.06.023

•The condition of the soft tissue and the shape of the acetabulum influence the hip stability after bipolar hemi arthroplasty.•The variance in acetabular morphology in patients with displaced femoral neck fractures remains unknown.•The purpose of this study was to clarify individual differences in the acetabula of Asian patients with displaced femoral neck fractures. The acetabular morphology varies greatly among individuals, and hypoplasia is more common in Asia than in Europe. Dislocation after bipolar hip arthroplasty (BHA) for femoral neck fracture occurs at a constant rate, and is affected by the acetabular morphology. This study aimed to clarify individual differences in the acetabula of Asian patients with displaced femoral neck fractures. Fifty patients with displaced femoral neck fractures were assessed (50 fractured hips, 50 non-fractured hips). On CT corrected by the anterior pelvic plane, the 100 hips were assessed regarding acetabular coverage (six parameters), acetabular depth (two parameters), and acetabular opening angle (four parameters). Additional parameters related to the fracture and sex were examined. The percentile of each parameter was shown for all hips. There was no patient with hip dysplasia defined as superior acetabular sector angle (SASA) less than 110° Compared with men, women had a significantly smaller anterior acetabular sector angle (AASA) (p = 0.016), and significantly larger acetabular inclination angle (p = 0.006) and acetabular index angle (p = 0.034). In the group with a normal SASA, seven hips (7.3%) had an anterior wall defect (AASA