scholarly journals Evaluation of femoral neck shaft angle on plain radiographs and its clinical implications

2016 ◽  
Vol 2 (4) ◽  
pp. 383 ◽  
Author(s):  
Subodh Kumar Pathak ◽  
Pritam Maheshwari ◽  
Prahlad Ughareja ◽  
Daksh Gadi ◽  
Prashanth Raj M. ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Indian Subcontinent ◽  
Slipped Capital Femoral Epiphysis ◽  
Orthopedic Implants ◽  
Developmental Dysplasia ◽  
Neck Of Femur ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
The Mean ◽  
Picture Archiving And Communication

<p class="abstract"><strong>Background:</strong> The femoral neck-shaft angle is the measurement of the angle formed between the oblique oriented neck with the vertical shaft and is an important anatomic measurement for the evaluation of biomechanics of hip.<span> The neck shaft angle is important in surgeries that involve the neck of femur, Intertrochanteric fractures, slipped capital femoral epiphysis, and developmental dysplasia of hip. Different variation of neck shaft angle has been seen in different literature and all the orthopedic implants are designed according to the values of the western literature which is different from the Indian subcontinent</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>Pelvic radiographs of patients who presented to Accident and emergency care or the outpatient department were used in the study</span> 110 patients radiographs were assessed in the study. There were 55 males and 55 females in our study. The mean age for males was 46.5 years and that for females was 43.2 years. The pelvis radiographs were studied for neck shaft angle .The measurements were performed bilaterally on the digital screen using the PACS (picture archiving and communication system) with handheld 360 degree goniometer.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean neck shaft angle in our study was129.26 degree for males and 126.62 degree for females .The overall mean neck shaft angle in 110 radiographs was 128.60 degree<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We conclude that consideration of neck shaft angles in orthopedics surgery and designing of implant can give more angle options for the surgeons which can improve the overall prognosis of the patient.</span></p>

scholarly journals A COMPARATIVE STUDY OF NECK SHAFT ANGLE OF FEMUR IN CENTRAL INDIAN POPULATION

2021 ◽  
pp. 1-3
Author(s):  
Vivek Kumar ◽  
Vivekanand Murlidhar Gajbhiye
Keyword(s):  
Femoral Neck ◽  
Indian Population ◽  
Femoral Shaft ◽  
Mean Value ◽  
Developmental Dysplasia ◽  
Neck Shaft Angle ◽  
Geographical Variations ◽  
Shaft Angle ◽  
The Mean ◽  
The Right

Background: In the fields of forensics, anthropology, orthopaedics, and human kinematics, the thigh bone femur is widely studied. The clinical significance of the femoral neck shaft angle lies in the diagnosis, treatment and monitoring of femoral neck fractures, trochanteric fractures, slipped upper femoral epiphysis, and hip developmental dysplasia. Objective: The present study was conducted to compare the NSA disparity between femurs on both sides and to compare the NSA with the Western and Indian population sizes of different regions. This research therefore leads to Indian data on these parameters. Materials and Methods: A total of 150 (75 right and 75 left) dry femur were used for measuring the neck shaft angle. Unpaired t-test was used to compare right and left femora. Results: The mean value of neck shaft angle was 126.04±5.05°. It ranges between 1130 to 1360. The mean value of right side was 125.92±4.9° and left side was measured 127.43±5.2°. There was no significant correlation between right and left neck shaft angle. Conclusion: The mean left femoral neck shaft angle was higher than the right femoral shaft in the present analysis, but the values were not statistically important. The angle of the neck shaft was lower than most studies in the Western population, but it was similar to most other studies in India. In the Indian population, geographical variations in the angle of the neck shaft also occur. In the field of orthopaedic surgery and anthropometry, this research will be of benefit.

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.

scholarly journals Valgus Osteotomy Outcome for Treating Femoral Neck Nonunion in Young and Active Patients

2021 ◽  
Vol 8 (2) ◽  
pp. 65-70
Author(s):  
Kaveh Gharanizadeh ◽  
◽  
Hamed Tayyebi ◽  
Abbas Esmaeli ◽  
Maziar Rajei ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Limb Length Discrepancy ◽  
Osteotomy Site ◽  
Valgus Osteotomy ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
The Mean

Background: Femoral neck fracture nonunion is a frequent and challenging complication, with several surgical options. Objectives: The present study reported the outcome of valgus osteotomy for treating femoral neck nonunion in patients aged <65 years. Methods: This case series research included young patients who underwent valgus osteotomy for treating femoral neck nonunion or device failure of the index surgery. The fixation of the osteotomy site was performed using either a dynamic hip screw or a fixed angle blade. The union of the neck and osteotomy site (subtrochanteric region) was evaluated by monitoring callus formation in the postoperative radiographs. Limb length discrepancy, Pauwels’ angle, and the neck-shaft angle were evaluated before the surgery and at the last follow-up. Postoperative complications were extracted from the explored patients’ profiles. Results: Twenty patients with a Mean±SD age of 27.2±10.8 years were examined in this study‎. The Mean±SD follow-up time of the patients was 6.1±3.9 years. The femoral neck was united in 18 patients in a Mean±SD period of 5.1±2.3 months. The Mean±SD limb length discrepancy was measured as 1.3±0.8 cm before and 0.5±0.7 cm after the ‏osteotomy. The Mean±SD Pauwels’ angle was calculated as 65.5±16.9º before and 32.4±16.2º after the osteotomy. The Mean±SD neck-shaft angle was computed to be 121.9±22.8º before and 144.5±17.7º after the osteotomy. Revision surgery was performed for 6 (30%) patients. This measure included device removal in 4 and total hip arthroplasty in 2 patient. Conclusion: Valgus osteotomy is a safe and efficient technique for managing femoral neck nonunion. Therefore‎, this approach is suggested as a good alternative for total hip arthroplasty, particularly in young and active patients‎.

scholarly journals MORPHOMETRY OF NECK-SHAFT ANGLE IN DRIED ADULT HUMAN FEMORA OF NORTH INDIAN POPULATION

2021 ◽  
pp. 135-137
Author(s):  
GURPREET SINGH ◽  
GURSHARAN SINGH DHINDSA
Keyword(s):  
Geometric Modeling ◽  
Indian Population ◽  
Neck Of Femur ◽  
Neck Shaft Angle ◽  
Adult Human ◽  
Prosthetic Implants ◽  
Significant Difference ◽  
Shaft Angle ◽  
The Mean ◽  
The Right

Objectives: The present study aimed to record the femoral-neck shaft angle was carried out which would be of help to the orthopedicians while carrying out surgical repairs around the hip joint especially in fracture of the neck of femur. Materials and Methods: A total of 100 North Indian unpaired dry adult human femora (Right-50, Left-50) of unknown sex were studied. Neck-shaft angle (NSA) of the femur was measured with the help of goniometer and measurements were recorded in degrees. The raw data obtained were statistically analyzed. Range, mean, standard deviation, and standard error of mean were determined. Results: The mean NSA was found to be 127.63°+3.48° (Right=127.80°+3.56° and Left=127.46°+3.42°) with a range of 122°–137° (Right=122°–137° and Left=122°–136°). No significant difference in values of neck-shaft angle was found in the right and left femora. Conclusion: The overall goal of this study was to generate information that would be useful for geometric modeling of femora and collecting data which could prove useful for the development of prosthetic implants

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 The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Christoph Kolja Boese ◽  
Michael Frink ◽  
Janine Jostmeier ◽  
Stefan Haneder ◽  
Jens Dargel ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Reference Values ◽  
Interrater Reliability ◽  
High Reliability ◽  
Age Groups ◽  
Absolute Difference ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
The Mean ◽  
Novel Concept

Background. The femoral neck-shaft angle (NSA) is of high importance for the diagnostics and treatment of various conditions of the hip. However, rotational effects limit its precision and applicability using plain radiographs. This study introduces a novel method to measure the femoral NSA: the modified NSA (mNSA), possibly being less susceptible against rotational effects compared to the conventional NSA.Patients and Methods. The method of measurement is described and its applicability was tested in 400 pelvis computed tomography scans (800 hips). Age- and gender-dependent reference values are given and intra- and interrater reliability are analyzed.Results. The mean age of all 400 patients (800 hips) was 54.32 years (18–100, SD 22.05 years). The mean mNSA was 147.0° and the 95% confidence interval was 146.7°–147.4°. Differences of the mNSA between sexes, age groups, and sides were nonsignificant. The absolute difference between NSA and mNSA was 16.3° (range 3–31°; SD 4.4°); the correlation was high (0.738;p<0.001). Overall, the intra- and interrater reliability were excellent for the mNSA.Interpretation. We introduced a novel concept for the analysis of the neck-shaft angle. The high reliability of the measurement has been proven and its robustness to hip rotation was demonstrated.

scholarly journals AGE AND GENDER DIFFERENCES IN MODIFIED FEMORAL NECK-SHAFT ANGLE: AN MRI BASED OBSERVATIONAL STUDY

2020 ◽  
pp. 1-4
Author(s):  
Najamul Huda ◽  
Ankur Agarawal* ◽  
Man Mohan Sharma ◽  
Saurabh Agarwal
Keyword(s):  
Femoral Neck ◽  
Age Group ◽  
Age And Gender ◽  
Neck Shaft Angle ◽  
Mri Scans ◽  
Shaft Angle ◽  
The Mean ◽  
The Difference ◽  
Gender Based ◽  
And Gender

Background: Femoral neck-shaft angle has its importance in describing biomechanics of hip. Measurement methods like plain radiography and CT scans have its limitations. The modied neck-shaft angle (mNSA) drawn on MRI scans is less susceptible to rotational effects and is more reliable for getting normal values. The present study was undertaken to assess the neck shaft angle on MRI and establish differences according to age and gender. Methods: Total 200 adults were recruited and equally distributed under four study cohorts according to age and gender. MRI of hip joint was analysed and mNSA was measured using pre-dened axial lines and landmarks. Results: The mean age of the participants was 49.76±18.184 years (18 to 87 years). The mean mNSA was 147.855o. Males had signicantly higher mean mNSA (149.93±6.61)o than females (145.78±5.71)o. Though the younger age group (<60 years) had higher mNSA values (148.32±6.65) than older (> 60years) age group (147.3900±6.35), the difference was not statistically signicant. Conclusions: We conclude that gender-based variation exists in the population with the higher values of mNSAin males as compared to females in any age group. The age based difference is also present, but it is not signicant. Neck shaft angle calculated on the MRI has the advantage that it is unaffected by rotation of the hip and is radiation free. The orthopaedic surgeons can use the mNSAfor the diagnosis and planning surgeries around hip, for designing implants and prosthesis. It can also be of help for the forensic anthropologists and to the anatomists. Multicentric studies may be undertaken to include a larger population.

scholarly journals Assessment of Femoral Neck-shaft Angle on Plain X-rays and its Clinical Implications

2021 ◽  
pp. 841-844
Author(s):  
N. Adhishwar Kumaran ◽  
B. Jagadeesh ◽  
Ashok Kumar ◽  
K. P. Niveditha
Keyword(s):  
Femoral Neck ◽  
Neuromuscular Disorders ◽  
Local Population ◽  
Tertiary Care ◽  
X Rays ◽  
College Hospital ◽  
Cross Sectional ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
The Mean

Background: Femoral neck-shaft angle is an important parameter for evaluating the biomechanics of the hip joint. It plays a pivotal role in surgeries for developmental dysplasia of the hip, neuromuscular disorders of the lower limb, proximal femoral fractures, Total Hip Arthroplasty, Perthes disease etc., It is also considered to hold an extensive bearing while designing orthopaedic implants. Aim: This study aimed to evaluate the femoral neck-shaft angle of proximal femur on plain radiographs of our local population Study Design: Retrospective study Methods: This cross-sectional study was done at Saveetha medical college hospital, a tertiary care institute in Chennai. 50 pelvic X-rays of patients aged between 30 to 70 who presented to the outpatient or emergency care department were used in the study.  Using a goniometer the femoral neck shaft angle was measured in the plain X - ray. Results: The mean age of the population in our study was 47.12. And the mean femoral neck shaft was 132.6 in males and 124.9 in females.

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.

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