scholarly journals Femoral neck shaft angle in relation to the location of femoral stress fracture in young military recruits: femoral head versus femoral neck stress fracture

2020 ◽  
Author(s):  
Dong-Kyu Kim ◽  
Tae Ho Kim
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Stress Fracture ◽  
Roc Analysis ◽  
Fracture Group ◽  
Neck Shaft Angle ◽  
Group A ◽  
Femoral Neck Stress Fracture ◽  
Shaft Angle ◽  
Group B

Abstract Objective To evaluate the influences of the femoral neck shaft angle (FNSA) on the location of the femoral stress fracture and to assess the potential differences in FNSA between fractured and normal femurs. Materials and methods Thirty-seven patients with femoral stress fractures who underwent both plain hip radiographs and MRI, from January 2016 to September 2019, were retrospectively included. Patients were classified as having either femoral head stress fracture (group A, n = 26) or femoral neck stress fracture (group B, n = 11). The FNSA was measured in anteroposterior (AP) hip radiograph. The Mann-Whitney U testing was used to compare the continuous values between the two groups. A receiver operating characteristic (ROC) analysis was used to evaluate the value of FNSA for predicting the risk of femoral stress fracture. Results The FNSA was significantly higher in group A (median 135.9°, range 129.5–138.6°) than group B (median 124.3°, range 119.5–129.0°) (p < 0.001), but there were no significant differences in other clinical factors. Furthermore, the FNSA was significantly higher at the fractured femurs (median 135.9°, range 129.9–138.6°) than contralateral normal femurs (median 127.9°, range 123.8–132.1°) in the patients with unilateral femoral head stress fracture (n = 22) (p < 0.001). The ROC analysis revealed that the area under curve (AUC), sensitivity, and specificity for predicting the risk of femoral head stress fracture were 0.807, 72.7%, and 68.2%, respectively, at a FNSA cutoff of 131.0°. Conclusion FNSA was associated with the location of the femoral stress fracture. In addition, FNSA could serve as a predictive factor for the risk of femoral head stress fractures.

The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model

2021 ◽  
pp. 112070002110130
Author(s):  
Leigh-Anne Tu ◽  
Douglas S Weinberg ◽  
Raymond W Liu
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Osteoarthritis ◽  
Volume Ratio ◽  
Femoral Head Coverage ◽  
Neck Shaft Angle ◽  
Hip Arthritis ◽  
Femoral Version ◽  
Shaft Angle ◽  
The Impact

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip. Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. We measured true neck shaft angle using an AP photograph with the femoral neck parallel to the table. Femoral head volume to acetabular volume ratio, representing femoral head coverage, as well as femoral version were utilised. Correlation between neck shaft angle, femoral version, femoral head coverage and osteoarthritis were evaluated with multiple regression analysis. Results: The mean age and standard deviation was 56 ± 10 years. There were 64 females (12%) and 469 males. There were 380 Caucasians (71%) and 153 African-Americans. Mean femoral version was 11° ± 12° and mean true neck shaft angle was 127.7° ± 5.9° There was a strong correlation between age and arthritis (standardised beta 0.488, p < 0.001). There was a significant correlation between increasing true neck shaft angle and decreasing hip arthritis (standardised beta -0.024, p = 0.038). In the femoral head overcoverage subset, increasing true neck shaft angle was still significantly associated with decreasing hip arthritis (standardised beta −0.088, p = 0.018), although this relationship was not significant with femoral head undercoverage subset. Conclusions: With sufficient acetabular coverage, a relative increase in femoral neck shaft angle within the physiologic range is associated with decreased hip osteoarthritis. Clinical relevance: An understanding of the relationship between femoral neck shaft angle and hip osteoarthritis could be useful for surgeons planning pelvic or proximal femur osteotomies in children.

scholarly journals Bilateral stress fracture of the femoral neck in association with simultaneously developing osteonecrosis of the femoral head: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tomofumi Nishino ◽  
Hisashi Sugaya ◽  
Naoya Kikuchi ◽  
Yu Watanabe ◽  
Hajime Mishima ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Femoral Neck ◽  
Stress Fracture ◽  
Overuse Injury ◽  
Early Stage ◽  
Stress Fractures ◽  
Resonance Imaging ◽  
Femoral Neck Stress Fracture

Abstract Background Femoral neck stress fractures are rare and often recognized as overuse injuries that occur in young athletes or military personnel. A case following osteonecrosis of the femoral head is quite rare; even more uncommon is its occurrence in the bilateral hips. Magnetic resonance imaging has been established as the preferred tool for diagnosing nondisplaced femoral neck stress fracture due to overuse injury. Magnetic resonance imaging was also useful to detect the initial lesion even in this case, although the etiology was different between overuse injury and insufficiency fracture. Case presentation A 41-year-old Japanese woman diagnosed with bilateral early stage idiopathic osteonecrosis of the femoral head was observed non-weight-bearing as much as possible using a stick. However, her pain and difficulty in walking progressed. Bilateral femoral neck stress fractures were subsequently detected by magnetic resonance imaging. The fracture initially appeared as a spot of bone marrow edema at the medial site of the femoral neck, and then developed into a fracture line. The patient underwent internal fixation of both hips with sliding hip screws to stabilize the stress fractures. In addition, the preparatory reaming served as core decompression of the femoral heads, as well as being treatment for osteonecrosis. Her bone mineral density and 25-hydroxy vitamin D values were low for her age. We administered eldecalcitol and teriparatide acetate. Her symptoms mostly improved, and the fracture lines and necrotic lesions on magnetic resonance imaging reduced at 5 months after the surgery. Conclusions Bilateral femoral neck stress fractures are a very rare condition and are often missed. It is important to listen to the patient’s complaints and perform an appropriate examination. We encountered a case of bilateral femoral neck stress fracture that occurred in a patient with early stage osteonecrosis of the femoral head, and were able to observe progression of stress fracture since before fracture occurred. This is considered to be the first report to capture imaging changes before and after the onset.

scholarly journals Avascular necrosis of the femoral head following an occult femoral neck stress fracture: A case report and mini-review

2021 ◽  
pp. 63-63
Author(s):  
Feng Cheng ◽  
Jian He
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Femoral Neck ◽  
Avascular Necrosis ◽  
Stress Fracture ◽  
Femoral Head Necrosis ◽  
Occult Fracture ◽  
Anterolateral Thigh ◽  
Femoral Neck Stress Fracture ◽  
Resected Femoral

Introduction. Osteonecrosis of the femoral head (ONFH) is an intractable disease that causes progressive femoral head collapse, severe pain, and gait disturbance. We report a case of avascular necrosis of the femoral head following an occult femoral neck stress fracture, which shows that early diagnosis and treatment are very important. Case report. A 55-year-old woman presented to our department with a chief complaint of low back pain that radiated into the left anterolateral thigh for 2 months Her left anterolateral thigh became progressively more painful over a period of about 2 weeks. No abnormal findings indicative of ONFH or an occult fracture of the femoral neck were detected by X-ray or computed tomography (CT), but an occult insufficiency fracture of the left femoral neck was identified on magnetic resonance imaging (MRI). The diagnosis of femoral neck stress fracture was delayed, resulting in femoral head necrosis. The fracture was treated with total hip arthroplasty and the resected femoral head was subjected to histopathology. Based on the histopathological findings, the final diagnosis of this case was ONFH with an occult fracture of the left femoral neck. Clinical symptoms were relieved postoperatively. Conclusion. In patients presenting with a suspected stress fracture of the femoral neck, early MRI examination is recommended to avoid femoral head necrosis due to a delayed diagnosis.

scholarly journals Radiographic analysis of the proximal femoral anatomy in the Croatian population

2021 ◽  
Author(s):  
Hrvoje Mokrovic ◽  
Simona Komen ◽  
Leo Gulan ◽  
Gordan Gulan
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Radiographic Evaluation ◽  
Neck Length ◽  
Femoral Offset ◽  
Head Diameter ◽  
Neck Shaft Angle ◽  
Femoral Neck Anteversion ◽  
Femoral Head Diameter ◽  
Shaft Angle

Abstract Purpose The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Accurate reconstruction of hip anatomy largely depends on the implant design. In order to select an implant in correspondence with the native hip, the proximal femoral morphology has been in focus of many studies in the past years. The purpose of this study is to analyze proximal femoral geometry in the Croatian population by radiographic evaluation. Methods We conducted a retrospective study analyzing conventional radiographies of the hip, obtained within the last four years from the database of Clinic for Orthopaedic Surgery Lovran. The number of studied patients was 300,168 women and 132 men. The proximal femoral geometric parameters assessed were as follows: femoral head diameter, femoral neck length, neck-shaft angle, angle of femoral neck anteversion, and lateral femoral offset. The results obtained were compared between genders and with results of other studies. Results Proximal femoral anatomy differed in femoral head diameter and lateral femoral offset between males and females in our group of patients, while femoral neck length, femoral neck shaft angle, and femoral neck anteversion have shown similar values in both genders. Our study also showed specificity of the Croatian population in almost all parameters of proximal femoral anatomy, in comparison with other ethnic groups. Conclusion Our results support the observation on high diversity in the morphology of the proximal femur and the specificity of the proximal femoral anatomy of the Croatian population.

Femoral neck stress fracture in children

2014 ◽  
Vol 23 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Mehmet S. Er ◽  
Mehmet Eroglu ◽  
Levent Altinel
Keyword(s):  
Femoral Neck ◽  
Stress Fracture ◽  
Femoral Neck Stress Fracture

Synovial Inclusion Cyst Mimicking a Femoral Neck Stress Fracture in an Active Duty Servicemember

2021 ◽  
Vol 11 (1) ◽  
pp. e20.00571-e20.00571
Author(s):  
Matthew J. Nowak ◽  
Donald A. Schultz ◽  
Daniel J. Cognetti
Keyword(s):  
Femoral Neck ◽  
Stress Fracture ◽  
Active Duty ◽  
Inclusion Cyst ◽  
Femoral Neck Stress Fracture

scholarly journals Simultaneous Morscher’s osteotomy and arthroscopic debridement in the management of Legg–Calvé–Perthes disease: a case report and literature review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. i4-i8
Author(s):  
Batool Bosakhar ◽  
Hassan Baldawi ◽  
Kathy Liu ◽  
Olufemi R Ayeni ◽  
Waleed Kishta
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Femoral Neck ◽  
Perthes Disease ◽  
Labral Repair ◽  
Coxa Vara ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Outcome Tool

Abstract There is a lack of consensus around optimal surgical management for Legg–Calvé–Perthes Disease (LCPD). This case report discusses the benefits of combining arthroscopic femoral neck osteochondroplasty and labral repair with Morscher’s Osteotomy (MO) for LCPD. S.A. is a 17-year-old female diagnosed with LCPD at the age of 6 years and has long-standing right hip symptoms. An arthroscopic femoral neck osteochondroplasty and labral repair followed by MO was performed. The pre-operative and 8 months post-operative International Hip Outcome Tool (iHOT-12) scores were 16.3 and 79.8 out of 100, respectively, indicating better quality-of-life. Also, the femoral neck-shaft-angle (NSA) changed from 120 pre-operative to 138.7 post-operative to represent the correction of coxa vara. The literature review revealed no published reports describing combined MO with hip arthroscopic interventions in managing LCPD. Combined arthroscopic femoral neck osteochondroplasty (with labral repair) and MO provides high patient satisfaction and improves radiographic parameters in patients with LCPD.

scholarly journals Sexual Variations of Femoral Neck-Shaft Angle in the Population of Odisha

2021 ◽  
Vol 10 (19) ◽  
pp. 1387-1390
Author(s):  
Rajeev Kumar Kanchan ◽  
Sonali Subhadarsini ◽  
Dharma Niranjan Mishra ◽  
Chinmayi Mohapatra
Keyword(s):  
Femoral Neck ◽  
Ventral Surface ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Legal Cases ◽  
Male And Female ◽  
Neck Shaft Angle ◽  
Femur Neck ◽  
Shaft Angle ◽  
The Right

BACKGROUND The peculiar waddling gait of a female attracts most of the anatomists to measure and compare the neck-shaft angle (NSA) of the femora. The femoral neck shaft angle is greater in women due to greater pelvic breadth and shorter femur. Neck-shaft angle was measured by the angle that the neck makes with the shaft of the femur and it is measured on the ventral surface of femur taking the long axis of femoral neck with the long axis of the proximal end of the femur. It gives information about the race it belongs to and normally measures 120° to 140°. The intention of this study was to establish the femoral neck shaft angle variations in adult male and female for medico-legal and anthropometric studies. METHODS This cross-sectional study was conducted on 84 adult human femora of unknown sex in the anatomy department, Sriram Chandra Bhanja (SCB) Medical College, Cuttack, Odisha, from May 2018 to April 2019. We included all the femora which were free of damage or deformity and fully ossified indicating adult bone. Femora with any pathological changes i.e., cortical bone deterioration, extreme osteophyte activity, osteoarthritis and fracture etc. were excluded from the study. The NSA was measured by protractor and goniometer. RESULTS In the present study the NSA range for the right femur of male was 108° - 135° and for the right femur of females 117° - 135°. The left male femur was 118° - 135° and the left female femur was 120° - 135°. The mean neck shaft angle of male femora was 125.9° and the female femora was 125.7°. These measurements show that the values were more in males than the females. The value of the present study was statistically significant between male and female i.e., P < 0.0001. CONCLUSIONS These measurements are important in the medico-legal cases, reconstructive orthopaedic surgeries, hip replacement surgeries and also while constructing suitable prosthesis. This will also be helpful in the detection of sex by anatomists and forensic experts. KEY WORDS Neck Shaft Angle, Medico-Legal, Anthropometry and Goniometer

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