Hip fractures have high morbidity and mortality rate for the people as a complication of osteoporosis and is generally seen in old age. It is known that femoral geometric measurements are important in the assessment of hip fracture risks. This study aimed to examine the association between hip geometry and hip fracture in post-menopausal elderly females. In the present study, 232 hip X-rays were taken from women with no hip fractures (Group 1) and 29 post-menopausal women with hip fractures (Group 2) after a minor trauma. After standard anterior-posterior plain pelvic X-ray radiographs were obtained, various radiographic measurements were performed in all cases, including the hip axis length (HAL), femoral neck axis length (FAL), acetabular width (AW), femoral head width (HW), femoral neck width (FW), femoral shaft width (FSW), intertrochanteric width (TW), lateral and medial cortical thickness of the femoral shaft (LCT, SMCT), femoral neck cortical thickness (NMCT) and femoral neck-shaft angle (Q-angle). In group 1, the mean age, weight and height were 62.5 +/-7.4 years, 70.8 +/-12.5 kg, and 157.5 +/-6.7 cm, respectively. In group 2, these values were 70.17 +/-6.8 years, 64.7 +/-11.5 kg, and 158.3 +/-2.7 cm, respectively. There were no statistically significant differences in the measurements of HAL, FAL, AW and HW between the two groups. In group 2, the mean FW value was significantly higher than in group 1 (p= 0.01). The mean values for FSW, TW, NMCT, SMCT, LCT were statistically lower in group 2 than those in group 1 (p= 0.01, p=0.038, p=0.001, p< 0.001, p< 0.001, respectively). Q-angle was also significantly higher in cases with hip fracture than in cases with no hip fracture (p=0.01). The values of FW, FSW, TW, NMCT, SMCT, LCT and Q-angle seem to be important parameters in the evaluation of hip fracture risks. However, further studies are needed to clarify this conclusion.
Aged ; Body Mass Index ; Female ; Femur/*anatomy & histology ; Femur Neck/anatomy & histology ; Hip Fractures/*pathology ; Humans ; Middle Aged

OBJECTIVE: To measure the anatomic data of the proximal femur and to design an internal fixation instrument aiming at subtrochanteric fracture. METHODS: We measured the anatomic data of 56 pairs of the matching proximal femur specimens: the diameter of femoral head (HD), the axis length of femoral head (HAL), 135 degree femoral head-neck axis length (HNAL), 135 degree femoral head-neck axis upper length (HNAUL), 135 degree femoral head-neck axis underside length (HNADL), the anterior-posterior axis diameter of femoral neck (NAPD), the upper-underside diameter of femoral neck (NUUD), femoral neck-shaft angle (NFA), femoral shaft lateral cortex-greater trochanter angle (SLGA), the medial-lateral diameter of lesser trochanter level's femoral shaft (LSMLD), the anterior-posterior diameter of lesser trochanter level's femoral shaft (LSAPD), the medial-lateral diameter of 5 cm below lesser trochanter femoral shaft (5 cm MLD), and the anterior-posterior diameter of 5 cm below lesser trochanter femoral shaft (5 cm APD). Part of the data was analyzed and compared. RESULTS: HD was (46.69+/-3.73) mm, HAL was (39.22+/-4.17) mm, HNAL was (95.45+/-8.16) mm, HNAUL was (84.02+/-7.11) mm, HNADL was (99.95+/-9.34) mm, NAPD was (26.27+/-3.15) mm, NUUD was (32.24+/-3.31) mm, NFA was 126.21 degree+/-7.13 degree, SLGA was 16.38 degree+/-4.04 degree, LSMLD was (31.05+/-3.57) mm, LSAPD was (27.63+/-2.96) mm, 5 cm MLD was (26.36+/-3.22) mm, and 5 cm APD was (25.59+/-2.75) mm. NFA was positively correlated with SLGA (r=0.396, P=0.003). CONCLUSION It is necessary to design internal fixator to fit the anatomical feature of Chinese femur for the treatment of subtrochanteric fracture, and we should thoroughly consider the angle of the SLGA.
Anthropometry ; Cadaver ; Equipment Design ; Femur Head ; anatomy & histology ; Femur Neck ; anatomy & histology ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans

OBJECTIVETo study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion (ROM) for activities of daily living in total hip arthroplasty (THA).

METHODSA three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion > or =120 degree internal rotation > or = 45 degree at 90 degree flexion, extension > or = 30 degree and external rotation > or =40 degree was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stem-neck (CCD)-angle of 130 degree theoretical safe-zones fulfilling the desired ROM were investigated at different general head-neck ratios (GR=2, 2.17, 2.37, 2.61 and 2.92) and femoral anteversions (FA equal to 0 degree,10 degree,20 degree and 30 degree).

RESULTSLarge GRs greatly increased the size of safe-zones and when the CCD-angle was 130 degree, a GR larger than 2.37 could further increase the size of safe-zones. There was a complex interplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130 degree the optimum relationship between operative acetabular anteversion (OA) and femoral antetorsion (FA) could be estimated by the formula: OA equal to -0.80 multiply FA+47.06, and the minimum allowable operative acetabular inclination (OI(min)) would be more than 210.5 multiply GR(-2.255).

CONCLUSIONSLarge GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination (OI), surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients'individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.

Acetabulum ; anatomy & histology ; Arthroplasty, Replacement, Hip ; methods ; Computer Simulation ; Femur Head ; anatomy & histology ; physiology ; Femur Neck ; anatomy & histology ; physiology ; Humans ; Range of Motion, Articular

OBJECTIVETo discern the differences between femoral neck anteversion (FNA) and torsion angle through 3D CT reconstruction.

METHODSFrom March 2010 to October 2010,30 healthy adult volunteers' femur were reconstructed by 3D CT, included 15 males and 15 females with an average age of (43.66 +/- 7.57) years old ranging from 25 to 65 years. Display the FNA and the torsion angle by image post-processing, measuring torsion angle by "Center way" and direct measurement of FNA.

RESULTSFNA was the angle between the axle wire of femoral neck and the shape face of femoral,the angle were (13.326 +/- 6.085) degrees. Torsion angle was the angle between the macropinacoid of cross section of femoral neck and the shape face of femoral, the angle were(31.335 +/- 2.079) degrees. There was no significant difference in left and right femur.

CONCLUSIONFNA is different from torsion angle. FNA is the angle between the line and the surface with the sharp angle towards the lower outside. The torsion angle is the angle between the two surfaces with the sharp angle towards the lower back.

Adult ; Aged ; Female ; Femur Neck ; anatomy & histology ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods

OBJECTIVE: To evaluate the association between alpha angle and herniation pit on MRI in asymptomatic hip joints and their associations with demographic variables. MATERIALS AND METHODS: Hip MRI of 185 asymptomatic hip joints of 105 adults (age 18 to 80 years) from September 2011 through December 2012 were retrospectively studied. Alpha angles were measured on oblique axial MR images by 2 observers. Herniation pit was determined by 1 observer. Size measures, prevalence, and statistical analyses were conducted regarding its association with age, gender, laterality (right or left hip). Intra- and inter-observer agreements were determined by intra-class correlation coefficient. RESULTS: The prevalence of herniation pit in asymptomatic hips was 21.6%. The range of alpha angle was 27.6-65.0 degrees. Seventeen and 16 out of 185 (9.1% and 8.6%) hip joints showed alpha angle of ≥ 55 degrees in first and second measurement sessions, respectively. There was no association between alpha angle ≥ 55 and presence of herniation pit. There was no association between alpha angle ≥ 55 and the size of herniation pit. Inter-observer agreement of alpha angle was 0.485 between first measurements of first vs. second observer, respectively. Intra-observer agreement of alpha angle was 0.654, respectively. Forty (21.6%) of 185 hip joints (35 of 105 patients, 33.3%) had herniation pit, with no difference according to age, gender, or laterality of hip joint. CONCLUSION: There is no association between alpha angle ≥ 55 degrees and presence of herniation pit or demographic variables.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asymptomatic Diseases ; Female ; Femur Neck/anatomy & histology/radiography ; Hip Joint/anatomy & histology/*radiography ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Young Adult

INTRODUCTIONThe morphology of the proximal femur has often been investigated in the literature, but the normal population ranges and standard deviations have still not been determined for this area. This study aimed to determine the age-, gender- and body mass index (BMI)-related changes in the femoral neck, especially on the neck-shaft angle, by using dual-energy X-ray absorptiometry (DXA) measurements.

METHODSRetrospective analyses of DXA images of the proximal femur from 18,943 individuals aged 20-108 years were performed. The age, gender, weight and height of each individual were obtained at the time of bone measurement. Data on theta angle were obtained from DXA measurements. Simple linear regression analysis and Pearson's correlation coefficients were used to investigate the relationships between theta and age, gender and BMI.

RESULTSThere was a significant correlation between theta and age (p < 0.001). We also found a significant difference between the various age groups using analysis of variance (p < 0.001), but there was no meaningful correlation between theta and BMI (p = 0.377) and the BMI groups (p = 0.180). There were small but statistically significant differences in the neck-shaft angle between males and females (p < 0.05).

CONCLUSIONIn this study, DXA-based measurements were used and many parameters of proximal femur geometry were calculated with limited radiation exposure. We have demonstrated that the mean neck-shaft angle is greater in males than in females, and that theta increases with age. We also found a significant difference between different age groups, but no meaningful correlation between theta and BMI.

Absorptiometry, Photon ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Biomechanical Phenomena ; Body Mass Index ; Female ; Femur Neck ; anatomy & histology ; diagnostic imaging ; Humans ; Linear Models ; Male ; Middle Aged ; Reference Standards ; Reference Values ; Retrospective Studies ; Sex Distribution