{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:31:18Z","timestamp":1760149878077,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003052","name":"Ministry of Trade, Industry and Energy (MOTIE, Republic of Korea)","doi-asserted-by":"publisher","award":["20016543"],"award-info":[{"award-number":["20016543"]}],"id":[{"id":"10.13039\/501100003052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Although numerous radiologic parameters of abnormal hip joint morphology are utilized in practice, studies on the relation of these parameters to acetabular fractures are limited. This study hypothesized that certain morphological features of hip joints are associated with acetabular posterior wall (PW) fracture patterns and aimed to identify morphological characteristics predictive of acetabular PW fracture. The records of 107 consecutive patients, who were diagnosed with acetabular fractures in a level I trauma center from August 2017 to April 2021, were initially reviewed. After excluding patients who lacked proper radiographic evaluation and had previous surgery or concomitant injury on the ipsilateral lower limb, a total of 99 patients were analyzed to investigate the morphological characteristics of the hip joint, measured in computed tomography, associated with acetabular posterior wall fracture. We included patient demographics, acetabular index (AI), sharp angle, acetabular depth-to-width ratio (AD\/WR), center-edge angle (CEA), head\u2013neck offset ratio (HNOR), acetabular head index (AHI), anterior acetabular sector angle (AASA), posterior acetabular sector angle (PASA), and acetabular version angle (AVA) in the univariate and multivariate analyses. The injury mechanism (p = 0.001) and AD\/WR (p = 0.021) were predictors of PW fracture in the univariate analysis. In the multivariable analysis, injury mechanism (p = 0.011), AI (coefficient B = 0.320; Exp (B) = 1.377; p = 0.017), and AD\/WR (coefficient B = 33.047; Exp (B) = 2.250 \u00d7 1014; p = 0.028) were significant predictors of PW fracture. This study highlights the importance of morphological factors, such as a larger AI and AD\/WR, that may influence joint stress distribution, resulting in acetabular PW fracture. Understanding these pathomechanisms may protect the hip joint and prevent future injuries through the early identification and treatment of pathological conditions.<\/jats:p>","DOI":"10.3390\/jpm13091406","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T01:32:50Z","timestamp":1695173570000},"page":"1406","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association between Hip Joint Morphology and Posterior Wall Fracture: Analysis of Radiologic Parameters in Computed Tomography"],"prefix":"10.3390","volume":"13","author":[{"given":"Han Soul","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Gachon University Gil Medical Center, Incheon 21556, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki Uk","family":"Mun","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gachon University Gil Medical Center, Incheon 21556, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-5358","authenticated-orcid":false,"given":"Chul-Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/1460408608094125","article-title":"Acetabular fractures in the 21st century","volume":"10","author":"Rickman","year":"2008","journal-title":"Trauma"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1016\/j.injury.2020.06.016","article-title":"Surgical management of acetabular fractures\u2014A contemporary literature review","volume":"51","author":"Kelly","year":"2020","journal-title":"Injury"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.1007\/s11999-014-3462-8","article-title":"The Epidemiology and Injury Patterns of Acetabular Fractures: Are the USA and China Comparable?","volume":"472","author":"Mauffrey","year":"2014","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_4","first-page":"139","article-title":"Current management of posterior wall fractures of the acetabulum","volume":"64","author":"Moed","year":"2015","journal-title":"Instr. Course Lect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"752","DOI":"10.2106\/00004623-200205000-00008","article-title":"Results of operative treatment of fractures of the posterior wall of the acetabulum","volume":"84","author":"Moed","year":"2002","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/00015458.2001.12098637","article-title":"Posterior wall fractures of the acetabulum: Characteristics, management, prognosis","volume":"101","author":"Rommens","year":"2001","journal-title":"Acta Chir. Belg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/00005131-200005000-00002","article-title":"Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns","volume":"14","author":"Saterbak","year":"2000","journal-title":"J. Orthop. Trauma"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2298\/ACI1302065M","article-title":"Avascular necrosis of the femoral head in the patients with posterior wall acetabular fractures associated with dislocations of the hip","volume":"60","author":"Milenkovic","year":"2013","journal-title":"Acta Chir. Iugosl."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s00590-021-02931-3","article-title":"Current concepts: Managing acetabular fractures in the elderly population","volume":"31","author":"Vipulendran","year":"2021","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.jos.2021.12.004","article-title":"Acetabular fractures in elderly","volume":"28","author":"Park","year":"2021","journal-title":"J. Orthop. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"758","DOI":"10.2106\/JBJS.N.01037","article-title":"Acetabular fractures in the elderly: Evaluation and management","volume":"97","author":"Butterwick","year":"2015","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11999-013-3375-y","article-title":"Classifications in Brief: Letournel Classification for Acetabular Fractures","volume":"472","author":"Alton","year":"2014","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1007\/s11999-011-1925-8","article-title":"The Use of an Algorithm for Classifying Acetabular Fractures: A Role for Resident Education?","volume":"469","author":"Ly","year":"2011","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1007\/s00264-020-04806-4","article-title":"Fractures of the acetabulum: From yestertday to tomorrow","volume":"45","author":"Cimerman","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001424","article-title":"Acetabulum fractures: Classification and management","volume":"33","author":"Letournel","year":"2019","journal-title":"J. Orthop. Trauma"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1148\/rg.352140098","article-title":"Acetabular Fractures: What Radiologists Should Know and How 3D CT Can Aid Classification","volume":"35","author":"Scheinfeld","year":"2015","journal-title":"Radiographics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1007\/s11999-014-4103-y","article-title":"How are dysplastic hips different? A three-dimensional CT study","volume":"473","author":"Wedge","year":"2015","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1007\/s11999-014-4038-3","article-title":"What are the radiographic reference values for acetabular under- and overcoverage?","volume":"473","author":"Tannast","year":"2015","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s11999-007-0060-z","article-title":"The etiology of osteoarthritis of the hip: An integrated mechanical concept","volume":"466","author":"Ganz","year":"2008","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Mimura, T., Mori, K., Kitagawa, M., Ueki, M., Furuya, Y., Kawasaki, T., and Imai, S. (2017). Multiplanar evaluation of radiological findings associated with acetabular dysplasia and investigation of its prevalence in an Asian population: A CT-based study. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1426-3"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"W100","DOI":"10.2214\/AJR.14.13130","article-title":"Prevalence of Imaging Features on CT Thought to Be Associated With Femoroacetabular Impingement: A Retrospective Analysis of 473 Asymptomatic Adult Hip Joints","volume":"205","author":"Kim","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4103\/0019-5413.93681","article-title":"Femoral head-neck offset in the Indian population: A CT based study","volume":"46","author":"Malhotra","year":"2012","journal-title":"Indian J. Orthop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1302\/0301-620X.87B1.15605","article-title":"Operative treatment of displaced fractures of the acetabulum. A meta-analysis","volume":"87","author":"Giannoudis","year":"2005","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.bone.2019.07.004","article-title":"Structural risk factors for low-energy acetabular fractures","volume":"127","author":"Gebre","year":"2019","journal-title":"Bone"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1302\/0301-620X.87B7.15203","article-title":"Hip morphology influences the pattern of damage to the acetabular cartilage: Femoroacetabular impingement as a cause of early osteoarthritis of the hip","volume":"87","author":"Beck","year":"2005","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1359\/jbmr.060305","article-title":"Association of geometric factors and failure load level with the distribution of cervical vs. trochanteric hip fractures","volume":"21","author":"Pulkkinen","year":"2006","journal-title":"J. Bone Min. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1007\/s11999-009-1185-z","article-title":"Influence of acetabular and femoral version on fractures of the femoral neck","volume":"468","author":"Frost","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1007\/s11999-016-5119-2","article-title":"Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations with CT","volume":"475","author":"Wells","year":"2017","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1007\/s11999-013-2863-4","article-title":"Femoroacetabular impingement predisposes to traumatic posterior hip dislocation","volume":"471","author":"Steppacher","year":"2013","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3390","DOI":"10.1007\/s11999-012-2468-3","article-title":"Is posterior hip instability associated with cam and pincer deformity?","volume":"470","author":"Krych","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.joca.2013.11.003","article-title":"Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia","volume":"22","author":"Henak","year":"2014","journal-title":"Osteoarthr. Cartil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1097\/CORR.0000000000001289","article-title":"Which Acetabular Landmarks are the Most Useful for Measuring the Acetabular Index and Center-edge Angle in Developmental Dysplasia of the Hip? A Comparison of Two Methods","volume":"478","author":"Shin","year":"2020","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1177\/0300060517709816","article-title":"Effects of the acetabular fracture index and other factors of posterior wall acetabular fracture on functional outcome","volume":"45","author":"Long","year":"2017","journal-title":"J. Int. Med. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"60","DOI":"10.3109\/17453674.2013.765626","article-title":"The role of the acetabular labrum in hip dysplasia. A literature overview","volume":"84","author":"Troelsen","year":"2013","journal-title":"Acta Orthop."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.12669\/pjms.38.8.5915","article-title":"Morphometric study of acetabular depth and coverage and their clinical importance","volume":"38","author":"Khaliq","year":"2022","journal-title":"Pak. J. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/BPO.0000000000000791","article-title":"Normal Percentile Reference Curves and Correlation of Acetabular Index and Acetabular Depth Ratio in Children","volume":"38","author":"Novais","year":"2018","journal-title":"J. Pediatr. Orthop."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1093\/jhps\/hnw035","article-title":"Imaging of femoroacetabular impingement-current concepts","volume":"3","author":"Albers","year":"2016","journal-title":"J. Hip Preserv. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1406\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:54:08Z","timestamp":1760129648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,20]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jpm13091406"],"URL":"https:\/\/doi.org\/10.3390\/jpm13091406","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2023,9,20]]}}}