Proximal Femoral Anatomy in the Normal Human Population
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
In this study, we developed a complete description of the morphology of the proximal femur. Then, using this framework, we (1) determined normal population means, standard deviations, and ranges; (2) established differences among subpopulations; and (3) showed correlations among the various measurements. To accomplish these objectives, we analyzed 375 adult femurs. Specimens were digitally photographed in standardized positions, measurements being obtained using ImageJ software. Three parameters of the head-neck relationship were assessed. Translation was examined through four raw offset measurements (anterior, posterior, superior, inferior) used to calculate anterior-posterior and superior-inferior ratios. Rotation was investigated through anteroposterior (AP) and lateral physeal angles. Concavity was examined using alpha, beta, gamma, and delta angles. Two parameters of the neck-shaft relationship were assessed, neck version and angle of inclination. Average anterior-posterior and superior-inferior ratios were 1.14 and 0.90. Average AP and lateral physeal angles were 74.33° and 81.83°, respectively. Averages for alpha, beta, gamma, and delta angles were 45.61°, 41.85°, 53.46°, and 42.95°, respectively. Average neck version and angle of inclination were 9.73° and 129.23°, respectively. Differences existed between males and females and between those younger and older than 50 years. Correlations were observed between translation and concavity, and translation and the neck-shaft relationships.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
- Billing L. Roentgen examination of the proximal femur end in children and adolescents: a standardized technique also suitable for determination of the collum-, anteversion-, and epiphyseal angles. A study of slipped epiphysis and coxa plana. Acta Radiol Suppl. 1954;110:1–80.
- Cooper AA. Treatise on Dislocations and Fractures of the Joints. 2nd ed. Boston, MA: Lilly and Wait et al; 1832.
- Dunlap K, Shands AR Jr, Hollister LC Jr, Gaul JS Jr, Streit HA. A new method for determination of the torsion of the femur. J Bone Joint Surg Am. 1953;35:289–311.
- Dunn DM. Anteversion of the neck of the femur: a method of measurement. J Bone Joint Surg Br. 1952;34:181–186.
- Durham HA. Anteversion of the femoral neck in the normal femur and its relation to congenital dislocation of the hip. J Am Med Assoc. 1915;65:223–224.
- Elmslie RC. Aetiological factors in osteoarthritis of the hip-joint. Brit Med J. 1933:1–3.
- Goodman DA, Feighan JE, Smith AD, Latimer B, Buly RL, Cooperman DR. Subclinical slipped capital femoral epiphysis. J Bone Joint Surg Am. 1997;79:1489–1497.
- Hernandez RJ, Tachdjian MO, Poznanski AK, Dias LS. CT determination of femoral torsion. AJR Am J Roentgenol. 1981;137:97–101.
- Hoaglund FT, Low WD. Anatomy of the femoral neck and head, with comparative data from Caucasians and Hong Kong Chinese. Clin Orthop Relat Res. 1980;152:10–16.
- Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect: a MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83:171–176. CrossRef
- Kingsley PC, Olmsted KL. A study to determine the angle of anteversion of the neck of the femur. J Bone Joint Surg Am. 1948;30:745–751.
- Koczewski P. Radiological risk factors of bilaterality in unilateral slipped capital femoral epiphysis. Chir Narzadow Ruchu Ortop Pol. 2003:68:225–230.
- Koval KJ, Zuckerman JD. Handbook of Fractures. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2006.
- Lawrence RC, Helmick CG, Arnett FC, Devo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:778–799. CrossRef
- Leunig M, Casillas MM, Hamlet M, Hersche O, Nötzli H, Slongo T, Ganz R. Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand. 2000;71:370–375. CrossRef
- Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT. Femoral anteversion. J Bone Joint Surg Am. 1987;69:1169–1176.
- Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol. 1965;38:810–824. CrossRef
- Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53:406–419.
- Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–560. CrossRef
- Parsons FG. The characteristics of the English thigh-bone. J Anat Physiol. 1914;48(Pt 3):238–267.
- Pick JW, Stack JK, Anson BJ. Measurements on the human femur. I. Lengths, diameters and angles. Q Bull Northwest Univ Med Sch. 1941;15:281–290.
- Rogers SP. A method for determining the angle of torsion of the neck of the femur. J Bone Joint Surg. 1931;13:821–824.
- Ryder CT, Crane L. Measuring femoral anteversion: the problem and a method. J Bone Joint Surg Am. 1953;35:321–328.
- Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res. 2004;418:54–60. CrossRef
- Solomon L. Patterns of osteoarthritis of the hip. J Bone Joint Surg Br. 1976;58:176–184.
- Soutter R, Bradford EH. Twists in normal and in the congenitally dislocated femora. NY Med J. 1903;78:1071–1077.
- Stulberg SD, Cordell LD, Harris WH, Ramsey PL, MacEwen GD. Unrecognized childhood hip disease: a major cause of idiopathic osteoarthritis of the hip. Hip: Proceedings of the Third Open Scientific Meeting of the Hip Society. St Louis, MO: CV Mosby; 1975:212–228.
- Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81:1747–1770.
- Weiner DS, Cook AJ, Hoyt WA Jr, Oravec CE. Computed tomography in the measurement of femoral anteversion. Orthopedics. 1978;1:299–306. CrossRef
- Proximal Femoral Anatomy in the Normal Human Population
Clinical Orthopaedics and Related Research
Volume 467, Issue 4 , pp 876-885
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Orthopaedics, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, 2423 Overlook Road, Apartment 7, Cleveland Heights, OH, 44106, USA
- 2. Department of Orthopaedics, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, 11100 Euclid Ave., Cleveland, OH, 44106, USA