Abstract
AMAÇ: Femoroasetabular sıkışma, asetabulum ve proksimal femurun anormal ilişkisi sonrası meydana gelen periartritik değişikliklerin eşlik ettiği kalça ekleminin ağrılı bir hastalığıdır. Eklem hareketlerinin kısıtlanmasına yol açar ve bu durum kalçanın normal biyomekaniğini bozarak anormal yüklenmelere sebep olur. Bu çalışmanın amacı femoroasetabular sıkışmanın indirekt etki ile yüksek mortalite ve morbidite nedeni olan kalça kırığı riskini artırıp artırmayacağının araştırılmasıdır.
GEREÇ VE YÖNTEM: 1 Ocak 2015 – 1 Ocak 2020 tarihleri arasında hastanemiz acil servisine başvuran ve tarafımıza konsulte edilerek intertrokanterik femur kırığı olan 243 hasta ve femur boyun kırığı olan 126 hasta ile travma nedeniyle acil serviste değerlendirilen aynı yaş grubuna sahip ve yapılan pelvis AP grafi ve pelvis BT tetkiklerinde herhangi bir fraktür saptanmayan 250 bireyin verileri retrospektif olarak incelenmiştir. X-ray görüntülerde merkez kenar açısı, asetabuler indeks, anterior ofset, anterior ofset oranı ve Singh indeksi; pelvis BT kesitlerinde ise alfa açısı ölçüldü.
BULGULAR: Kalça kırığını oluşturan her iki grup ile kontrol grubu arasında cinsiyet, yaş ve Singh indeksi açısından anlamlı bir fark saptanmamış olup bu faktörler için gruplar arası homojen dağılımın gerçekleştiğini ve araştırılan faktörler üzerine etkisinin olmadığını göstermektedir. Merkez kenar açısı, asetabuler indeks, alfa açısı, anterior ofset ve anterior ofset oranının ise kalça kırığı bulunan grupta kontrol grubuna göre femoroasetabular sıkışma lehine anlamlı derecede farklı çıktığı görülmüştür.
SONUÇ: Femoroasetabular sıkışmanın kalça eklem artrozuna neden olduğu ve bunun da kalça eklemi biyomekaniğini bozduğu bilinmektedir. Çalışmamızda bozulan bu biyomekaniğe bağlı olarak indirekt yoldan kalça kırığı oluştuğu araştırılmış olup analiz sonuçları hipotezimizi destekleyerek femoroasetabular sıkışmanın kalça kırığına neden olabileceğini göstermektedir.
Keywords
intertrokanterik femur kırığı femur boyun kırığı femoroasetabular sıkışma intertrochanteric fracture femoral neck fracture femoroacetabular impingement
References
- 1. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.
- 2. Grantham WJ, Philippon MJ. Etiology and pathomechanics of femoroacetabular impingement. Curr Rev Musculoskelet Med. 2019;12(3):253–259.
- 3.Leunig M, Beaule´ PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467:616–622.
- 4. Mori R, Yasunaga Y, Yamasaki T, Nakashiro J, Fujii J, Terayama H, et al. Are cam and pincer deformities as common as dysplasia in Japanese patients with hip pain? Bone Joint J. 2014;96:172–176.
- 5. Agricola R, Heijboer MP, Ginai AZ, Roels P, Zadpoor AA, Verhaar JAN, et al. A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2- year follow-up. Am J Sports Med. 2014;42:798–806.
- 6. Hopkinson-Woolley JA, Parker MJ. Fractures of the hip: does the type of fall really affect the site of fracture? Injury. 1998;29(8):585–587.
- 7. Polesello GC, Queiroz MC, Ono NK, Honda EK, Guimaraes RP, Junior WR. Tratamento artroscópico do impacto femoroacetabular. Rev Bras Ortop. 2009;44(3):230–238.
- 8. Said HG, Masoud MA, Morsi MMA-H, El-Assal MA. Outcomes of hip arthroscopy for femoroacetabular impingement: The effect of morphological type and chondrolabral damage. Sicot-J. 2019;5:16.
- 9. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.
- 10. Steppacher S, Albers C, Siebenrock K, Tannast M, Ganz R. Femoroacetabular Impingement Predisposes to Traumatic Posterior Hip Dislocation. Clin Orthop Relat Res. 2013;471(6):1937-43.
- 11. Carey T, Key C, Oliver D, Biega T, Bojescul J. Prevalence of radiographic findings consistent with femoroacetabular impingement in military personnel with femoral neck stress fractures. J Surg Orthop Adv. 2013;22:54-58.
- 12. Kuhn K, Riccio A, Saldua N, Cassidy J. Acetabular Retroversion in Military Recruits with Femoral Neck Stress Fractures. Clin Orthop Relat Res. 2010;468:846–851.
- 13. Busato T, Baggio M, Morozowski M, Filho GRM, Godoi LD, Capriotti JRV. Increased prevalence of femoroacetabular impingement on the elderly with fractures of the proximal femur. Sicot-J. 2021;7:37.
Abstract
AIM: The aim of this study is to find out if there is a relationship between femoroacetabular syndrome and the risk of hip fractures that have been known with high morbidity and mortality rates.
MATERIAL AND METHOD: Between January 1st of 2015 and January 1st of 2020, data of 243 patients with intertrochanteric fracture, 126 patients with femoral neck fracture and 250 trauma patients of over 65 years old that had admitted to our hospital’s emergency department but had no fracture on both pelvis AP x-ray and pelvis CT, were evaluated retrospectively. While central edge angle, acetabular index and singh index were measured on AP x-ray of pelvis, alfa-angle, anterior offset and anterior offset ratio were measured on pelvis CT.
RESULTS: No significant differences were found between the groups forming the hip fracture and the control group in terms of gender, age and Singh index, indicating that these factors were homogeneously distributed between the groups and had no effect on the factors investigated (p>0.05). The central edge angle, acetabular index, alpha angle, anterior offset and anterior offset ratio were found to be significantly different (p<0.05) in both hip fracture group compared to the control group in favor of femoroacetabular impingement.
CONCLUSION: The analysis results support our hypothesis and show that femoroacetabular impingement may cause hip fracture. As a result, the relationship of femoroacetabular impingement with hip fractures, which is the cause of high mortality and morbidity should be kept in mind.
References
- 1. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.
- 2. Grantham WJ, Philippon MJ. Etiology and pathomechanics of femoroacetabular impingement. Curr Rev Musculoskelet Med. 2019;12(3):253–259.
- 3.Leunig M, Beaule´ PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467:616–622.
- 4. Mori R, Yasunaga Y, Yamasaki T, Nakashiro J, Fujii J, Terayama H, et al. Are cam and pincer deformities as common as dysplasia in Japanese patients with hip pain? Bone Joint J. 2014;96:172–176.
- 5. Agricola R, Heijboer MP, Ginai AZ, Roels P, Zadpoor AA, Verhaar JAN, et al. A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2- year follow-up. Am J Sports Med. 2014;42:798–806.
- 6. Hopkinson-Woolley JA, Parker MJ. Fractures of the hip: does the type of fall really affect the site of fracture? Injury. 1998;29(8):585–587.
- 7. Polesello GC, Queiroz MC, Ono NK, Honda EK, Guimaraes RP, Junior WR. Tratamento artroscópico do impacto femoroacetabular. Rev Bras Ortop. 2009;44(3):230–238.
- 8. Said HG, Masoud MA, Morsi MMA-H, El-Assal MA. Outcomes of hip arthroscopy for femoroacetabular impingement: The effect of morphological type and chondrolabral damage. Sicot-J. 2019;5:16.
- 9. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.
- 10. Steppacher S, Albers C, Siebenrock K, Tannast M, Ganz R. Femoroacetabular Impingement Predisposes to Traumatic Posterior Hip Dislocation. Clin Orthop Relat Res. 2013;471(6):1937-43.
- 11. Carey T, Key C, Oliver D, Biega T, Bojescul J. Prevalence of radiographic findings consistent with femoroacetabular impingement in military personnel with femoral neck stress fractures. J Surg Orthop Adv. 2013;22:54-58.
- 12. Kuhn K, Riccio A, Saldua N, Cassidy J. Acetabular Retroversion in Military Recruits with Femoral Neck Stress Fractures. Clin Orthop Relat Res. 2010;468:846–851.
- 13. Busato T, Baggio M, Morozowski M, Filho GRM, Godoi LD, Capriotti JRV. Increased prevalence of femoroacetabular impingement on the elderly with fractures of the proximal femur. Sicot-J. 2021;7:37.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original research article |
| Authors | |
| Publication Date | April 30, 2023 |
| Submission Date | December 14, 2022 |
| Published in Issue | Year 2023 Volume: 56 Issue: 1 |
