Femoral Neck Fractures: A New Risk Assessment Method Using CT Hounsfield Measurement

Objective: Hip fractures, which are a serious consequence of osteoporosis, lead to a decrease in life expectancy. Computed tomography (CT) Hounsfield unit (HU) measurements have been clinically utilized to assess fracture risk. Materials and Methods: This retrospective study, conducted between 2020-2023, analyzed 99 patients with femoral neck fractures and 62 controls who underwent pelvic CT. Two radiologists conducted bone density measurements using CT, with specific measurements at the femoral head, fracture level, and lesser trochanter. Statistical analyses, including Mann-Whitney U tests, Wilcoxon tests, chi-square tests, ROC curve analysis, and logistic regression analysis, were performed using SPSS version 28.0. Results: The study revealed significant differences in bone density measurements between the fractured and control groups. Proximal, middle, and distal values demonstrated significant differences in distinguishing between patients with and without fractures. The distal measurement was the most effective measure, with an area under the curve of 0.918. Conclusion: This study emphasizes the potential of CT HU measurements for predicting femur fracture risk, particularly the distal measurement at the minor trochanter level. Further research with larger samples and comparisons with other methods, such as dual X-ray absorptiometry or quantitative CT, are needed to validate these findings and their clinical significance.