scholarly journals Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuhui Yang ◽  
Weihong Liao ◽  
Weiqun Yi ◽  
Hai Jiang ◽  
Guangtao Fu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Medullary Canal ◽  
Femoral Offset ◽  
Neck Shaft Angle ◽  
Type Iv ◽  
Shaft Angle ◽  
Dysplasia Of The Hip

Abstract Background When performing femoral reconstruction in patients with Crowe type IV developmental dysplasia of the hip (DDH), anatomical deformity presents many technical challenges to orthopedic surgeons. The false acetabulum is suggested to influence load transmission and femoral development. The aim of this study was to describe the morphological features of dysplastic femurs in Crowe type IV DDH and further evaluate the potential effect of the false acetabulum on morphological features and medullary canal of Crowe type IV femurs. Methods We analyzed preoperative computed tomography scans from 45 patients with 51 hips (25 hips without false acetabulum in the IVa group and 26 hips with false acetabulum in the IVb group) who were diagnosed with Crowe type IV DDH and 30 normal hips in our hospital between January 2009 and January 2019. Three-dimensional reconstruction was performed using Mimics software, and the coronal femoral plane was determined to evaluate the following parameters: dislocation height, dislocation ratio, height of the femoral head (FH), height of the greater trochanter (GT), GT–FH height discrepancy, height of the isthmus, neck-shaft angle, femoral offset and anteversion of the femoral neck. The mediolateral (ML) width, anterolateral (AP) width and diameter of medullary canal of the proximal femur were measured on the axial sections. Further, canal flare index (CFI), metaphyseal-CFI and diaphyseal-CFI were also calculated. Results Compared with the normal femurs, the Crowe type IV DDH femurs had a higher femoral head, larger GT–FH height discrepancy, larger femoral neck anteversion, higher isthmus position and smaller femoral offset. Dislocation height and dislocation rate were significantly larger in the IVa DDH group (65.34 ± 9.83 mm vs. 52.24 ± 11.42 mm). Further, the IVb femurs had a significantly lower isthmus position, larger neck-shaft angle and smaller femoral neck anteversion than IVa femurs. The ML, AP canal widths and the diameter of medullary canal in both DDH groups were significantly smaller than the normal group. Dimensional parameters of IVa femurs were also narrower than IVb femurs in most sections, but with no difference at the level of isthmus. According to the CFIs, the variation of proximal medullary canal in IVb femurs was mainly located in the diaphyseal region, while that in IVa femurs was located in the whole proximal femur. Conclusions High dislocated femurs are associated with more anteverted femoral neck, smaller femoral offset and narrower medullary canal. Without stimulation of the false acetabulum, IVa DDH femurs were associated with higher dislocation and notably narrower medullary canal, whose variation of medullary canal was located in the whole proximal femur.

Radiographic Assessment of the Proximal Femoral Anatomy in An Indigenous African Adult Population

2021 ◽  
Vol 9 (3.1) ◽  
pp. 8034-8039
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Adult Population ◽  
Femoral Offset ◽  
Femoral Neck Axis ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
The Mean ◽  
Axis Length ◽  
Neck Diameter

Background: Hip surgeries such as fracture fixation, corrective osteotomy, hemiarthroplasty, or total hip arthroplasty require accurate preoperative templating for a successful outcome. Such templating is done using the proximal femur and the acetabulum radiographs, depending on the planned surgery. Understanding the normal radiographic anatomy of the proximal femur is crucial to differentiate a normal from pathological anatomy. Proximal femoral anatomic indices include the femoral head diameter, femoral neck diameter, femoral neck length, femoral offset, femoral neck axis length and the femoral neck-shaft angle. Aim: This study assesses and establishes the average values of the proximal femoral anatomy in an indigenous African adult population. Method: This cross-sectional study examined 190 normal anteroposterior (AP) radiographs of the pelvis. The mean age, weight and height of the subjects were obtained. The following proximal femoral anatomic parameters were measured: femoral neck length (FNL), femoral neck diameter (FND), femoral head diameter (FHD), femoral neck-shaft angle (FNSA), femoral offset (FO) and femoral neck axis length (FNAL). The authors compared the mean difference of the parameters between the genders and the age categories and assessed the parameter correlations with the patients’ weight and height. Results: Males constituted 63 (33.2%) of the study population. The mean age of the subjects was 51.46 years (SD = 16.37). The mean weight was 76.13 kg, while the mean height was 1.62 m. The mean values of the proximal femoral parameters were as follows: FNL 4.52cm, FND 3.42cm, FHD 4.76cm, FNSA 132.960, FO 4.09cm, and FNAL 10.34cm. Males have a significantly higher mean value in all the parameters except the FO. None of the parameters showed any significant difference among the age categories except the FNL. A post-hoc analysis showed that the difference in the FNL lies between the young and the elderly age groups. The subjects’ height correlated with all the parameters except FNSA, while the weight correlated with the FND, FNSA and FNAL. Conclusion: The proximal femoral anatomy in Africans differed from those published in foreign literature. This knowledge is crucial for implant manufacturing companies and preoperative templating for hip surgeries. KEY WORDS: Proximal femur, Anatomy, Black population.

Femoral neck-shaft angle and bone age in 4- to 24-year-olds based on 1005 EOS three-dimensional reconstructions

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ian R. O’Sullivan ◽  
Ádám T. Schégl ◽  
Péter Varga ◽  
Péter Than ◽  
Csaba Vermes
Keyword(s):  
Femoral Neck ◽  
Three Dimensional ◽  
Bone Age ◽  
Neck Shaft Angle ◽  
Shaft Angle

Computer-assisted three-dimensional correlation between the femoral neck-shaft angle and the optimal entry point for antegrade nailing

Injury ◽  
2009 ◽  
Vol 40 ◽  
pp. S11
Author(s):  
G. Anastopoulos ◽  
D. Chissas ◽  
J. Dourountakis ◽  
P.G. Ntagiopoulos ◽  
N. Zacharakis ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Three Dimensional ◽  
Entry Point ◽  
Computer Assisted ◽  
Neck Shaft Angle ◽  
Antegrade Nailing ◽  
Shaft Angle

Femoral Neck Shaft Angle and Management of Proximal Femur Fractures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Miranda J. Rogers ◽  
Taylor L. King ◽  
Jaewhan Kim ◽  
Temitope F. Adeyemi ◽  
Thomas F. Higgins ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Neck Shaft Angle ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Shaft Angle

scholarly journals Double Intertrochanteric Osteotomy for Trochanteric Overgrowth and a Short Femoral Neck in Adolescents

2016 ◽  
Vol 24 (3) ◽  
pp. 387-391 ◽  
Author(s):  
Turgut Akgul ◽  
Cengiz Şen ◽  
Halil Ibrahim Balci ◽  
Gokhan Polat
Keyword(s):  
Femoral Neck ◽  
Delayed Union ◽  
Developmental Dysplasia ◽  
Intertrochanteric Osteotomy ◽  
Coxa Vara ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Proximal Femoral Focal Deficiency ◽  
Femoral Side

Purpose To review the outcome of Wagner double intertrochanteric osteotomy for trochanteric overgrowth and a short femoral neck in 7 adolescents. Methods Records of one male and 6 females aged 15 to 20 years who underwent modified Wagner osteotomy for trochanteric overgrowth and a short femoral neck by a single senior surgeon were reviewed. The diagnoses were coxa vara (n=2), developmental dysplasia of the hip (n=3), Leg-Calve-Perthes (n=1), and proximal femoral focal deficiency (n=1). Radiological indication for double intertrochanteric osteotomy included a neck-shaft angle (NSA) <120° or a centre trochanter distance (CTD) <28 mm. Function was evaluated using the Children's Hospital Oakland Hip Evaluation Scale (CHOHES). The articulotrochanteric distance (ATD), CTD, NSA, and the distance between the centre of the femoral head and the centre of the acetabulum (MZ) were measured on radiographs. Results The mean follow-up duration was 61 (range, 28–86) months. The ATD improved from 16±11.5 mm to −6.3±10.2 mm (p=0.018), the CTD from 27.9±3.5 mm to 36.4±7.1 mm (p=0.018), the NSA from 112°±24.4° to 131°±16° (p=0.028), the MZ from 12.7±6.5 mm to 7.7±4.2 mm (p=0.028), and the CHOHES score from 62.1±8.7 to 84±9.6 (p=0.017). One patient had delayed union. Two patients had persistent Trendelenburg gait. Two patients declined second-stage surgery for acetabular dysplasia after solving the femoral side problems at the first stage. One of them developed hip arthrosis. Conclusion Double intertrochanteric osteotomy is a viable treatment option for adolescents with trochanteric overgrowth and a short femoral neck.

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.

scholarly journals Comparison of two different on-shelf femoral stems for Crowe type IV developmental dysplasia of the hip

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094788
Author(s):  
Tong Liu ◽  
Yuhui Yang ◽  
Xianyue Shen ◽  
Jianlin Xiao ◽  
Jianlin Zuo ◽  
...  
Keyword(s):  
Average Distance ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Type Iv ◽  
Negative Point ◽  
Femoral Stems ◽  
Modular Implants ◽  
Distance Deviation ◽  
Dysplasia Of The Hip ◽  
Comparison Technique

Objective This study was performed to evaluate the proximal anatomical compatibility of stems for treatment of Crowe IV developmental dysplasia of the hip (DDH) using a previously developed three-dimensional comparison technique. Methods Patients with Crowe IV DDH who underwent computed tomography were retrospectively analyzed. The femoral medullary canals were three-dimensionally reconstructed, and models of cementless modular (S-ROM; DePuy Synthes) and conical (Wagner Cone; Zimmer Biomet) implants were used for virtual implantation. The negative point percentages (NPPs) were applied to verify fitting. The average distance (deviation) and the root mean square of the distance (RMSd) were used to quantify geometric compatibilities. Results Four (16.7%) and 12 (50.0%) femoral medullary canals could not be fitted properly with either the modular or conical implant. The NPPs in the distal comparison region were significantly greater in the conical than modular group. The deviation was significantly smaller in the modular than conical group. The RMSd was also significantly smaller in the modular than conical group. Conclusions Compared with conical implants, modular implants might be more effectively used in patients with Crowe type IV DDH. However, some Crowe IV DDH femurs with severe deformity cannot be fitted with either of these two on-shelf implants.

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