Evidence map›Paper›PMID 42154258›Full record

SynthesisSurgical and radiologic anatomy : SRA2026

Proximal femoral morphometry and its association with hip fracture patterns: a systematic review with meta-analysis.

Dimitrios Kotzias, Vasileios Giovanoulis, Christos Koutserimpas, George Triantafyllou, Enejd Veizi, Nikolaos-Achilleas Arkoudis, George Tsakotos, Theodore Troupis, Maria Piagkou

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
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Synthesis in Surgical and radiologic anatomy : SRA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Dimitrios KotziasDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece.
Vasileios GiovanoulisLyon Ortho Clinic, Clinique de la Sauvegarde, Lyon, France.
Christos KoutserimpasSchool of Health Rehabilitation Sciences, University of Patras, Patras, Greece.
George TriantafyllouDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece.
Enejd VeiziDepartment of Orthopaedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey.
Nikolaos-Achilleas ArkoudisResearch Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, Athens, Greece.
George TsakotosDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece.
Theodore TroupisDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece.
Maria PiagkouDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece. mapian@med.uoa.gr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposesProximal femoral fractures (PFFs) represent a major cause of morbidity and mortality in the elderly population. Beyond bone mineral density, proximal femoral (PF) and hip joint (HJ) morphometry have been implicated in fracture susceptibility and fracture pattern. However, the relative contribution of individual geometric parameters remains incompletely defined. The purpose of this study was to systematically evaluate the association between PF and HJ morphometry and hip fracture (HF) patterns, and to assess the predictive value of radiographic morphometric parameters derived from standard anteroposterior radiographs. MATERIALS AND

methodsA systematic review with meta-analysis was conducted in accordance with PRISMA guidelines. PubMed and MEDLINE databases were searched up to September 2025 for observational studies reporting radiographic morphometric parameters in patients with unilateral PFFs. Statistical meta-analysis was performed with random-effect models to compare intracapsular-ICF/subcapital-SCF fractures with intertrochanteric (ITF) and extracapsular (ECF) fracture patterns.

resultsTwenty-two studies comprising 4184 patients (77.8% female; pooled mean age 77.4 years) were included. Meta-analysis using a random-effects model revealed that ITF were significantly associated with a smaller femoral head diameter (p < 0.001) and increased medial neck cortex thickness (p = 0.021) compared with ICF. ECF demonstrated significantly longer femoral neck axis length (p = 0.012), increased horizontal offset (p = 0.048), smaller absolute offset (p = 0.026) and shorter hip axis length (p = 0.026) than ICFs. Angular parameters provided the most robust stratification. ITFs and ECFs exhibited significantly lower (more varus) neck-shaft angles (p < 0.001) and significantly higher Wiberg angles (p < 0.001) compared with the ICF group.

conclusionsPF and HJ morphometry are associated with distinct HF patterns, independently of bone mineral density. Simple linear and angular measurements obtained from standard anteroposterior radiographs may assist fracture pattern stratification, risk assessment, and preoperative planning in elderly patients.

Indexed as

Femur HeadHip FracturesHip JointAgedBone DensityFemaleFemur NeckHumansRadiographyElderly patientsHip fracture patternsHip fracturesProximal femoral morphometryRadiographic geometry

Identifiers

PMID42154258
PMCPMC13186906

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.