Is the femoral neck-shaft angle an independent risk factor for hip fractures? An observational study

Background: The femoral neck-shaft angle (FNSA) has been implicated in the aetiology of hip fractures. The longer moment arm of a higher FNSA has been theorized to impart a greater deforming force to the greater trochanter, which may cause a hip fracture.Methods: A prospective study that involves adults with hip fractures and a control group matched for age and sex. The FNSA of both groups were measured on an anteroposterior X-ray of the pelvis. The mean FNSA were compared with a paired samples t-test, and a binary logistic regression analysis was run with the FNSA as a predictor variable and the presence of hip fracture as an outcome variable.Results: A total of 150 patients were recruited for the study, 75 per group. The mean age of patients with hip fractures was 71.30 years (S.D.=14.34), and that of the control group was 73.94 years (S.D.=12.55), p=0.264. The mean FNSA of the study group was 133.96o (S.D.=3.77) while that of the control group was 131.05o (S.D.=3.86), p<0.001. Increasing FNSA imparts a higher risk of having a hip fracture, O.R.=1.24 (95% C.I, 1.12-1.37).Conclusions: Individuals with higher FNSA demonstrated a significantly increased risk of developing hip fractures. However, the exact cut-off point of the FNSA, which predisposes to the risk of these fractures, remains to be elucidated.

Common Errors in Proposals and Dissertations and How to Avoid them: A Resident’s Guide

Background: The dissertation is now a necessary part of the fellowship examinations of both the West African college of surgeons and physiciansand the national postgraduate medical college of Nigeria. Many resident doctors are confused about how to get on with their proposals and thedissertations. This confusion often leads to frustrations, and in extreme cases to unnecessary delay in attempting the examinations when due. Aim: This study aims to identify the common errors made by resident doctors in the proposal and dissertations and to recommend the solutionsto such problems. Methods: This survey is based on a direct interview with experienced examiners in both colleges. The examiners were asked to list what they observed as the common problems they identified concerning the proposal and dissertation of residents. The answers were collated and categorized according to the frequencies of problems identified. Based on the response of the examiners, a questionnaire was designed and administered to the senior residents who are at various stages of writing their dissertations. Results: Some of the findings include starting the proposal too late, difficulty in choosing a topic, mediocre and tedious literature search, difficulty in finding appropriate supervisors, poor appreciation of basic research design and necessary statistical tests, improper presentation of results and  wrong referencing. Others are editorial mistakes, pagination errors, and the lack of knowledge on proper attitude and skill during the defense.  Conclusion: Starting too late is the most common error made by the resident doctor in the dissertation. Residents should choose a topic within 6  months of passing the membership examination. Keywords: Dissertations, errors, proposals, resident doctor