Vickers Micro-indentation Hardness Distribution On Whole Human Femur And Clinical Research Of Geriatric Hip Facture

Part one Vickers micro-indentation hardness distributions on whole human femur on Chinese DonorsObjective : The aim of this study was to investigate Vickers micro-indentation hardness distributions of the whole human femur on Chinese subjects.Method:From September 2015 to May 2017,we used the Vickers micro-indentation hardness tester to measure micro-hardness values on whole human femur of three Chinese donors' autopsy.Results : In this study,we depicted the distributions of Vickers micro-indentation hardness values on whole Chinese human femur.The Vickers micro-indentation hardness distributions on the femur follow certain rules.The mid-shaft was the hardest zone,from the mid-shaft to two ends of femur,Vickers micro-hardness decrease gradually.In the femoral shaft,the diaphysis was harder than metaphysis and epiphysis(all P<0.05),proximal of femur was harder than distal femur(all P<0.05),medial cortex was harder than lateral cortex(all P<0.05),anterior cortex was harder than posterior cortex(all P<0.05).The medial condyle was harder than lateral condyle(all P<0.05).Conclusions:The Vickers micro-indentation hardness distributions on the whole femur follow certain rules.Different skeletal sites have site specific Vickers micro-indentation hardness values.The mid-shaft of femur was the hardest site on the whole femur.Part two Comparison of proximal femoral geometry and risk factors between femoral neck fractures and femoral intertrochanteric fractures in Chinese elderly patientsObjective: The purpose of this study was to determine the association between proximal femoral geometry(PFG)and the risk factors of hip fracture in femur neck and trochanteric fractures in a Chinese elderly population.Methods: The study included 198 patients(101 patients with femoral neck fractures,97 patients with femoral intertrochanteric fractures).Data on PFG parameters including NSA,CEA,FHD,FND,FNAL,HAL,FSD and demographics(age,site,and gender)were recorded.Descriptive statistics and odds ratios of PFG parameters were obtained using logistic regressions.Results:There existed significant differences on the risk factors and proximal femoral geometry parameters between patients with two types of hip fractures.There were significant differences between two types of hip fractures on the NSA,CEA,FND and FNAL(P<0.001,P<0.001,P=0.027 and P < 0.001 respectively).Mean ages in patients with femoral intertrochanteric fractures were older than those with femoral neck fractures(P=0.014).CEA and FNAL were significant risk factors for trochanteric fractures(OR 1.15,P = 0.000,OR 1.17,P = 0.000).FND was protector factor for trochanteric fracture OR 0.74,P= 0.000).whereas,the NSA was significant risk factor for femoral neck fracture(OR 0.70,P = 0.000).Conclusions: The risk factors and proximal femoral geometry parameters differed by hip fracture type in Chinese elderly population.Which suggest that proximal femoral geometry could be independent predictors for determining whether femoral neck fracture or femoral trochanteric fracture occur at falling in Chinese elderly population.Part three Comparison of risk factors and routine laboratory parameters between femoral neck fractures and femoral intertrochanteric fracturesObjective: Data about clinical characteristics and laboratory parameters regard to hip fracture type are rare in Chinese elderly population.This study was aimed to assess the differences of risk factors and routine laboratory parameters on the patients with two types of hip fracture.Methods: Elderly patients aged 65 years and older(n = 198)were admitted to the orthopedic department with hip fractures from January 2017 to December 2017.Demographic,clinical data and routine blood tests parameters were retrieved from the patient electronic medical records.Results: There existed significant differences on the risk factors and routine laboratory parameter between patients with two types of hip fractures.Mean ages in patients with femoral intertrochanteric fractures were older than those with femoral neck fractures(P=0.014).Female sex,subnormal serum hemoglobin,albumin,serum calcium,magnesium,as well as abnormal glucose levels,were significant risk factors for trochanteric fractures(OR 2.58,P = 0.044,OR 10.84,P = 0.000,OR 2.70,P = 0.015,OR 2.23,P = 0.037,OR 3.03,P = 0.035,OR 2.27,P = 0.014,respectively).Conclusions: The clinical characteristic and laboratory parameters differ by hip fracture type in Chinese elderly population.Which suggest that the fracture type should be taken into account in clinical fracture risk assessment and in studies related to fracture prevention.Summary: 1.The Vickers micro-indentation hardness distribution on the whole femur follows certain rules.Different skeletal sites have site specific Vickers micro-indentation hardness values.The mid-shaft of femur was the hardest site on the whole femur.2.The risk factors and proximal femoral geometry parameters differed by hip fracture type in Chinese elderly population.Which suggest that proximal femoral geometry could be independent predictors for determining whether femoral neck fracture or femoral trochanteric fracture occur at falling in Chinese elderly population.3.The clinical characteristic and laboratory parameters differ by hip fracture type in Chinese elderly population.Which suggest that the fracture type should be taken into account in clinical fracture risk assessment and in studies related to fracture prevention.