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The femoral neck-shaft angle on plain radiographs: a systematic review

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Abstract

Objective

The femoral neck-shaft angle (NSA) is an important measure for the assessment of the anatomy of the hip and planning of operations. Despite its common use, there remains disagreement concerning the method of measurement and the correction of hip rotation and femoral version of the projected NSA on conventional radiographs. We addressed the following questions: (1) What are the reported values for NSA in normal adult subjects and in osteoarthritis? (2) Is there a difference between non-corrected and rotation-corrected measurements? (3) Which methods are used for measuring the NSA on plain radiographs? (4) What could be learned from an analysis of the intra- and interobserver reliability?

Material and methods

A systematic literature search was performed including 26 publications reporting the measurement of the NSA on conventional radiographs.

Results

The mean NSA of healthy adults (5,089 hips) was 128.8° (98–180°) and 131.5° (115–155°) in patients with osteoarthritis (1230 hips). The mean NSA was 128.5° (127–130.5°) for the rotation-corrected and 129.5° (119.6–151°) for the non-corrected measurements.

Conclusion

Our data showed a high variance of the reported neck-shaft angles. Notably, we identified the inconsistency of the published methods of measurement as a central issue. The reported effect of rotation-correction cannot be reliably verified.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann Str. 9, 50931, Cologne, Germany

    Christoph Kolja Boese, Jens Dargel, Johannes Oppermann, Peer Eysel, Max Joseph Scheyerer & Jan Bredow

  2. Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany

    Philipp Lechler

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  1. Christoph Kolja Boese
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  2. Jens Dargel
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Correspondence to Christoph Kolja Boese.

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Boese, C.K., Dargel, J., Oppermann, J. et al. The femoral neck-shaft angle on plain radiographs: a systematic review. Skeletal Radiol 45, 19–28 (2016). https://doi.org/10.1007/s00256-015-2236-z

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  • DOI: https://doi.org/10.1007/s00256-015-2236-z

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