Methods of Defining the Femoral Neck Axis for the Measurement of Femoral Antetorsion

ABSTRACT Objective: To prove the accuracy of a customized guide developed according to our method. Methods: This customized guide was developed from a three-dimensional model of proximal femur reconstructed using computed tomography data. Based on the new technique, the position of the guide pin insertion was selected and adjusted using the reference of the anatomical femoral neck axis. The customized guide consists of a hemispheric covering designed to fit the posterior part of the femoral neck. The performance of the customized guide was tested in eight patients scheduled for total hip arthroplasty. The stability of the customized guide was assessed by orthopedic surgeons. An intraoperative image intensifier was used to assess the accuracy. Results: The customized guide was stabilized with full contact and was fixed in place in all patients. The mean angular deviations in relation to the what was planned in anteroposterior and lateral hip radiographs were 0.5º ± 1.8º in valgus and 1.0º ± 2.4º in retroversion, respectively. Conclusion: From this pilot test, the authors suggest that the proposed technique could be applied as a customized guide to the positioning device for hip resurfacing arthroplasty with acceptable accuracy and user-friendly interface. Level of Evidence IV, Cases Series.

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Relationship between the Effect of Medial Rotation of the Foot Axis by Ankle Dorsiflexion and the Ability to Visualize the Femoral Neck Axis in the Hip Joint Anterio-posterior Radiography: Evaluation by Magnetic Resonance Images

Japanese Journal of Radiological Technology ◽

10.6009/jjrt.2012_jsrt_68.5.584 ◽

2012 ◽

Vol 68 (5) ◽

pp. 584-592

Author(s):

Takashi Hashido ◽

Tsukasa Doi ◽

Hiroaki Matsuzawa ◽

Kiyosumi Kawamoto

Keyword(s):

Magnetic Resonance ◽

Femoral Neck ◽

Hip Joint ◽

Magnetic Resonance Images ◽

Ankle Dorsiflexion ◽

Femoral Neck Axis ◽

Medial Rotation

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Differences in mineral homeostasis, volumetric bone mass and femoral neck axis length in black and white South African women

Osteoporosis International ◽

10.1007/bf01623684 ◽

1997 ◽

Vol 7 (2) ◽

pp. 105-112 ◽

Cited By ~ 52

Author(s):

E. D. Daniels ◽

J. M. Pettifor ◽

C. M. Schnitzler ◽

G. P. Moodley ◽

D. Zachen

Keyword(s):

Femoral Neck ◽

Bone Mass ◽

South African ◽

African Women ◽

Femoral Neck Axis ◽

Black And White ◽

Mineral Homeostasis ◽

Axis Length ◽

South African Women

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Ancestral differences in femoral neck axis length: Possible implications for forensic anthropological analyses

Forensic Science International ◽

10.1016/j.forsciint.2013.12.027 ◽

2014 ◽

Vol 236 ◽

pp. 193.e1-193.e4 ◽

Cited By ~ 11

Author(s):

Angi M. Christensen ◽

William D. Leslie ◽

Sanford Baim

Keyword(s):

Femoral Neck ◽

Femoral Neck Axis ◽

Axis Length

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Contribution to the method for determining femoral neck axis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1404178a ◽

2014 ◽

Vol 142 (3-4) ◽

pp. 178-183 ◽

Cited By ~ 2

Author(s):

Zoran Andjelkovic ◽

Desimir Mladenovic ◽

Zoran Vukasinovic ◽

Stojanka Arsic ◽

Milorad Mitkovic ◽

...

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Small Sample Size ◽

Alpha Angle ◽

Head Rotation ◽

Small Sample ◽

Femoral Neck Axis ◽

Rotation Center ◽

Head Translation ◽

Head Neck

Introduction. Femoral neck axis plotting is of great significance in measuring parameters that define femoral head-neck junction sphericity in the group of patients with the femoroacetabular impingement. Literature methods of femoral neck axis determination have weaknesses associated with the risk of obtaining inaccurate values of certain parameters. Objective. Method of plotting of the femoral neck axis by two parallel lines that belong to the medial quarter of the femoral neck is proposed. Method was tested on the anatomic specimens and the respective radiograms. Methods. A total of 31 anatomic specimens of the proximal femur and respective radiographs were used, on which three axes of the femoral neck were plotted; accordingly, alpha angle value was determined and tested with corresponding parametric tests, with the measurement error of less than 5% and the strength of the applied tests of 80%. Results. Alpha angle values obtained by plotting femoral neck axis using the literature and methods we have proposed were not significantly different in our series, and, in more than a half of the specimens, the two axes overlapped each other. Conclusion. The advantage of the proposed method does not depend on the position of the femoral head rotation center in relation to the femoral neck, which favors proposed method for measuring the angles of femoral head sphericity in patients with the femoral head translation. Disadvantage of the study is a small sample size for valid conclusions about the applicability of this method in clinical practice.

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Fractures of the upper part of the femur treated with Mitkovic selfdynamisable internal fixator (SIF)

Acta chirurgica iugoslavica ◽

10.2298/aci1004103m ◽

2010 ◽

Vol 57 (4) ◽

pp. 103-107 ◽

Cited By ~ 1

Author(s):

Milorad Mitkovic ◽

Marko Bumbasirevic ◽

Sasa Milenkovic ◽

Ivan Micic ◽

Milan Mitkovic ◽

...

Keyword(s):

Surgical Treatment ◽

Femoral Neck ◽

Blood Loss ◽

Operative Time ◽

Femoral Fractures ◽

Internal Fixator ◽

Average Period ◽

Femoral Neck Axis ◽

Invasive Method ◽

Average Operative Time

Complex transtrochanteric and subtrochanteric fractures need dynamisation in two axis: in neck axis and in the long axis of the femur. In this study is present one new concept of the surgical treatment of the fractures of proximal femur using new double dynamic selfdynamisable internal fixator (SIF). Dynamisation along the femoral neck axis is available immediately after the fixation, while dynamisation in the long axis of the femur is activated spontaneously 4-6 weeks after the fixation. It is shown series of 30 consecutive fractures of the upper femur. The average operative time was 42 minutes and average blood loss was 70 (seventy) milliliters. All fractures healed within an average period of sixteen weeks (ranging from 12 to 24 weeks). There were no serious complications. Conclusion: SIF is one effective minimally invasive method for the treatment of complex trochanteric and subtrochanteric femoral fractures.

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Comparing Two Different Automatic Methods to Measure Femoral Neck-Shaft Angle Based on PointNet++ Network

10.21203/rs.3.rs-1096475/v1 ◽

2021 ◽

Author(s):

Zhe Li ◽

Jiayu Yang ◽

Xinghua Li ◽

Kunzheng Wang ◽

Jungang Han ◽

...

Keyword(s):

Femoral Neck ◽

Femoral Shaft ◽

Femoral Neck Axis ◽

Neck Shaft Angle ◽

3D Space ◽

Significant Difference ◽

Shaft Angle ◽

Automatic Methods ◽

3D Methods ◽

2D And 3D

Abstract Bacnground: Accurate measurement of the femoral neck-shaft angle (NSA) is of great significance for diagnosing hip joint diseases and preoperative planning of total hip arthroplasty. However, the fitting lines of the femoral neck and femoral shaft did not always intersect in 3D space. Thus, it is unclear whether there is a difference between 2D and 3D methods for measuring NSA. Methods: The femoral point cloud datasets from 310 subjects were segmented into three regions, including the femoral head, femoral neck, and femoral shaft using PointNet++. We created a projection plane to simulate the hip anteroposterior radiograph and fitted the femoral neck axis and femoral shaft axis to complete the 2D measurement, while we directly fitted the two axes in space to complete the 3D measurement. Also, we conducted the manual measurement of the NSA. We verified the accuracy of the segmentation and compared the results of the two automatic and manual methods. Results: The Dice coefficient of femoral segmentation reached 0.9746, and MIoU of that was 0.9165. No significant difference was found between any two of the three methods. While comparing the 2D and 3D methods, the average accuracy was 98.00%, and the average error was 2.58°. Conclusion: This paper proposed two accurate and automatic methods to measure the NSA based on a 2D plane and a 3D model respectively. Although the femoral neck and femoral shaft axes did not intersect in 3D space, the NSAs obtained by 2D and 3D methods were basically consistent.

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The distribution of bone mineral density in the femoral heads of unstable intertrochanteric fractures

Journal of Orthopaedic Surgery ◽

10.1177/2309499018778325 ◽

2018 ◽

Vol 26 (2) ◽

pp. 230949901877832 ◽

Cited By ~ 1

Author(s):

Keisuke Uemura ◽

Masaki Takao ◽

Yoshito Otake ◽

Hidetoshi Hamada ◽

Takashi Sakai ◽

...

Keyword(s):

Bone Mineral Density ◽

Femoral Head ◽

Femoral Neck ◽

Lateral View ◽

Intertrochanteric Fractures ◽

Mineral Density ◽

Femoral Neck Axis ◽

Lag Screw ◽

Center Region ◽

Anteroposterior View

Purpose: Intertrochanteric fractures are usually treated with open reduction and internal fixation, but controversy still remains regarding the proper placement of the lag screw on the anteroposterior view. The stability of the lag screw has been shown to correlate with the bone quality around the screw, but the three-dimensional distribution of the bone mineral density (BMD) in the femoral head has not been studied in detail. Herein, the BMD along the femoral neck axis was measured to clarify the recommended position of the lag screw. Methods: Ten femoral heads acquired from intertrochanteric fractures were evaluated in this study. Each femoral head was scanned with micro computed tomography and the BMD along the femoral neck axis was measured in five regions: center, anterior, posterior, superior, and inferior. The BMD on the anteroposterior view (superior, center, and inferior) and the BMD on the lateral view (anterior, center, and posterior) were compared. Results: The BMD of the center region (173.0 ± 50.6 mg/cm3) was significantly higher than that of the inferior region (139.7 ± 50.1 mg/cm3) on the anteroposterior view ( p < 0.01). On the lateral view, the BMD was lower than the center region in the anterior region (165.7 ± 52.8 mg/cm3) and in the posterior region (157.5 ± 42.3 mg/cm3), but the difference was not significant. Conclusion: The BMD was higher in the center region of the femoral head than in the inferior region. Therefore, lag screws are recommended to be inserted into the center of the femoral head.

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Morphometric study of proximal femur in fractured and non-fractured post menopausal women

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.16761 ◽

2017 ◽

Vol 10 (4) ◽

pp. 313

Author(s):

Lopamudra Nayak ◽

Susmita Senapati ◽

Sitanshu Kumar Panda ◽

Prafulla Kumar Chinara

Keyword(s):

Femoral Neck ◽

Proximal Femur ◽

Morphometric Study ◽

Control Group ◽

Head Width ◽

Femoral Neck Axis ◽

Neck Shaft Angle ◽

The Mean ◽

Axis Length ◽

And Control

Objective: This study was conducted to investigate the risk of hip fracture using proximal femoral morphometry in fractured and nonfractured postmenopausal women.Methods: We conducted an observational cross-sectional study with 138 postmenopausal women (49 fractured and 89 nonfractured). The hip axis length (HAL), femoral neck axis length (FNAL), acetabular width (AW), femoral head width (FHW), femoral shaft width (FSW), and femoral neck shaft angle (FNSA) were measured in all cases by dual energy X-ray absorptiometry. We also studied the correlation between body mass index (BMI) with all the parameters in fractured and control groups.Results: The mean age, height, weight, and BMI were 61.24±3.23, 163.94±7.84 cm, 71.88±9.14 kg, and 26.72±2.78 kg/m², respectively, in fractured patients. In nonfractured patients the values were 59.73±5.32, 161.73±4.25 cm, 69.54±6.25 kg, and 26.74±2.23 kg/m² respectively. The mean HAL, FNAL, AW, FHW, FSW, and FNSA were 130.5±3.18 mm, 111.26±3.64 mm, 18.2±1.91 mm, 53.46±1.51 mm, 37.45±1.82 mm, and 132.76±3.15 degree incase group and 130.84±4.74 mm, 112.48±4.08 mm, 17.57±2.32 mm, 53.4±1.86 mm, 35.29±1.82 mm, and 128.76±3.6° in control group, respectively.Conclusion: The femoral parameters such as HAL, FNAL, AW, and FHW do not indicate any correlation between fractured and control groups, whereas FSW and FNSA were significantly higher in case group. The FNSA was having significant negative correlation with BMI in fractured group while that was having a significant positive correlation in the nonfractured group. This observation will be helpful in exploration of its clinical significance in proximal femoral fracture.Keywords: Proximal femur, Morphometry, Postmenopausal, Fracture.

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