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The Bristol Hip View: a new hypothetical radiographic projection for femoral neck fractures

Department of Radiology, Southmead Hospital, North Bristol Trust, Westbury on Trym, Bristol BS10 5NB, UK

This experimental study is to evaluate a modified radiographic view of the femoral neck in the assessment of femoral fractures. A dry femur and pelvis was set up in a rig to simulate the positioning of a routine anteroposterior (AP) pelvis X-ray view. Films were exposed to create a routine AP pelvis, AP hip and two views with external tube angulation of 15° and 30°. Observers were asked to evaluate the films using a visual analogue score on two separate occasions. The same films were performed on a further fractured femoral neck to assess the fracture clarity. There was good intraobserver and interobserver correlation. Observers ranked the 15° and 30° angled films as showing the femoral neck most clearly, over and above the traditional views (p<0.001). The fracture was best demonstrated on the 30° angled film (p<0.001). The 30° angled view appears to demonstrate the femoral neck anatomy more clearly than the traditional views but also showed increased fracture sharpness. The authors are proceeding to a clinical trial to assess this in trauma practice.

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