Introduction: The purpose of this study was to obtain computed tomography (CT) based measurements of femoral dimensions in adults, to identify its relevance with intramedullary nails used in the management of proximal femur fractures and to suggest a best fitting implant dimensions to our population. To best of our knowledge our study would be first to compile different CT based dimension in single study.
Methods: In our retrospective study of 50 femurs, CT based femoral dimensions measured in standardized cuts and compared with previous studies and commonly available proximal femur intramedullary devices.
Results: 68.4 was the mean age in our study, neck shaft angle (NSA) was 127.2±5.2, anteversion 11.2±7.4, endosteal isthmus diameter was 11.9 ± 1.7 mm, anterior radius of curvature (ROC) was 116.8 ± 20 mm, horizontal femoral offset 37.5 ± 4.6 mm, medio-lateral angle 7.8±1.6, with good inter and intra observer correlation. Femoral length and neck width was positively correlated to head diameter, horizontal femoral offset with medio-lateral (ML) angle. One of the 50 femur studied had the parameters in the range of available implant and could match appropriately.
Conclusion: CT based dimensions in our population is different from other population. Based on this study, a design modification of nails used in present day management of proximal femur fractures has been recommended.
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http://dx.doi.org/10.1016/j.jor.2019.12.002 | DOI Listing |
J Orthop Surg Res
January 2025
Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
Background: The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index.
View Article and Find Full Text PDFInjury
January 2025
Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; Department of Trauma, Hand- and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany. Electronic address:
Purpose: Standard operating procedures aim to achieve a standardized and assumedly high-quality therapy. However, in orthopaedic surgery, the aspect of temporal urgency is often based on surgical tradition and experience. At a time of evidence-based medicine, it is necessary to question these temporal guidelines.
View Article and Find Full Text PDFCan J Anaesth
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front St. SE, Calgary, AB, T3M 1M4, Canada.
Purpose: We report the use of a pericapsular nerve group (PENG) cryoneurolysis for longer-term analgesia in a patient with a hip fracture and severe medical comorbidities as an alternative to hip fracture surgery.
Clinical Features: A frail but lucid and fully autonomous 97-yr-old female from an assisted living facility sustained a subcapital fracture of her right proximal femur following a ground level fall. She had significant comorbidities including end-stage respiratory disease.
Acta Orthop Belg
December 2024
Due to the high incidence of proximal femoral fractures, classifications of these fractures are often used in daily practice. Most classifications are eponymous terms since they bear the name of the person(s) who developed them. In this study we provide an insight in the origin of the classifications and the background of their name givers.
View Article and Find Full Text PDFThe current study aimed to objectively evaluate the fit of a rectangular, tapered stem to the severely dysplastic hips on the basis of the proximal femoral anatomy and the dimensional properties of the stem. It was hypothesized that the stem size planned with accordance to the diaphyseal canal width alone can accommodate the distal femur successfully with no sizing mismatch. Forty-six patients (53 hips) suffering from secondary osteoarthritis due to hip dysplasia scheduled for total hip arthroplasty (THA) with a subtrochanteric transverse shortening osteotomy were included.
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