Predicting fracture classification and prognosis with hounsfield units and femoral cortical index: A simple and cost-effective approach.

Background: The relationship between bone density and fracture has been widely studied and recognized, and the role of cortical bone in proximal femoral fractures has also been increasingly studied. However, both the determination of bone mineral density (BMD) and the determination of cortical mass are expensive and cumbersome. The purpose of this study is to investigate whether two readily available indicators, Hounsfield Units (HUs) and femoral cortical index (FCI), can be used to predict hip fracture classification and prognosis.
Methods: A retrospective study was conducted on 110 patients with hip fragility fractures. Cortical index was calculated on fractured and contralateral femur FCI, with HUs calculated on the proximal femur. The correlation of the FCI and HU with diabetes, hypertension, and related indicators, such as albumin, creatinine, and urea nitrogen levels, were also analyzed in the study.
Results: Both the Evans classification of intertrochanteric fractures and the Garden and Pauwels classifications of femoral neck fractures showed that as the severity of the fracture increased, the HUs and FCI decreased. Age and albumin level also had a negative correlation with HUs and FCI. There was also a significant correlation between HUs and FCI.
Conclusions: The HUs and FCI, which can be easily and quickly obtained, can be used to predict the classification and prognosis of hip fractures.
Competing Interests: Declaration of competing interest On behalf of all authors, the corresponding author states that there is no conflict of interest.
(Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)