• Title/Summary/Keyword: Proximal femoral

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Comparison of Femoral Anteversion Angle and Determination of Reliability Measured at Three Different Anatomical References of the Tibial Crest During the Trochanteric Prominence Angle Test

  • Lee, Ji-Hyun;Yoon, Tae-Lim;Choi, Sil-Ah;Cynn, Heon-Seock
    • Physical Therapy Korea
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    • v.19 no.4
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    • pp.55-60
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    • 2012
  • The trochanteric prominence angle test (TPAT) has been used to measure the femoral anteversion angle between the tibial crest and the vertical line. However, the exact anatomical reference of the tibial crest has not yet been identified in the literature. Thus, the purposes of this research were twofold: first, to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest (the proximal tibial crest, the proximal third of tibial crest, and the proximal half of tibial crest) and, second, to determine inter-and intra-rater reliabilities of the femoral anteversion angle measured at these three different anatomical references of the tibial crest during the TPAT. We recruited 14 healthy subjects, and a total of 28 legs were examined. The TPAT was measured using a digital inclinometer. A 1-way repeated-measure analysis of variance was used to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest, and intraclass correlation coefficients (ICCs) were calculated to determine reliability. The femoral anteversion angle measured at the proximal tibial crest was significantly higher than that at the proximal third of the tibial crest and the proximal half of the tibial crest. The inter-and intra-rater reliabilities of femoral anteversion angle were measured at three anatomic references of the tibial crest were all found to be high during the TPAT (ICC=.9 0~.98). In conclusion, clinicians should recognize that the different degrees of the femoral anteversion angle could be measured when different anatomical references of the tibial crest were used, and that reliabilities were high when an exact anatomical reference of the tibial crest was used during the TPAT.

Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

A Comparison of Bone Mineral Density in Osteoporotic Facture of the Proximal Femur Using Dual Energy X-ray Absorptiometry (대퇴 근위부 골절환자에서 이중에너지 방사선흡수계측법을 이용한 부위별 골밀도 비교)

  • Lee, Jong-Seok;Kim, Keung-Sik;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.23 no.2
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    • pp.13-19
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    • 2000
  • There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and Febuary in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry(DEXA). The result was compared using age matched paired T test. The results were as follows ; 1. The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. 2. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. 3. The bone density of neck, Ward's triangle, trochanter(P<0.05) and lumbar spine(P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. 4. The bone density of neck, Ward's triangle, trochanter(P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. 5. The bone density of neck, Ward's triangle, trochanter and lumbar spine(P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities(BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.

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A Finite Element Analysis of Stress on the Femoral Stem with Resorption of Proximal Medial Femur after Total Hip Replacement (대퇴골 근위부 골흡수가 인공 고관절 대퇴 stem에 미치는 응력에 관한 연구-FEM을 이용한 분석)

  • 김성곤
    • Journal of Biomedical Engineering Research
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    • v.15 no.2
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    • pp.183-188
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    • 1994
  • In clinical orthopaedics, bone resoption in the cortex is often seen post operatively on X-rays or bone densitometry after total hip replacement (THR) in the form of cortical osteoporosis or atropy. Stress shielding of bone occurs, when a load, normally carried by the bone alone, is shared with an implant as a result, the bone stresses are abnormal and with remodelling analysis this may cause extensive proximal bone resoption, possibly weakening the bone bed to the point of failure. The author made finite element models of the cemented and non-cemented type implanted femoral stem with bone resorption of the proximal medial femur and studied the feed back effect of the various degree of bone resoption to THR system by parametric analysis on the stress of the femoral stem and interface. The results of the present finite element analysis implied that the extent of proximal bone resorption has the effect of more increasing stress on the distal stem tip, cement mantle and interface in both type of femoral stem and this high distal stress possibly can cause the mechanical failure of loosening or failure after THR.

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A Study for Improvement of the Femoral Stem Type using the Finite Element Analysis (유한요소법을 이용한 인공고관절 주대형태의 개선에 대한 연구)

  • 윤경렬;원예연;이수훈
    • Korean Journal of Computational Design and Engineering
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    • v.5 no.2
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    • pp.122-126
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    • 2000
  • A major mechanical problem with total hip replacement is the loosening of the femoral component. The loss of proximal support, with firm fixation distally, has been thought to be a major caused of fatigue failure of femoral stems. While many causes have been proposed, the most frequently suggested cause of the calcar resorption is the disuse atrophy of the cortex of the calcar due to the stress shielding of the proximal bone by the metal femoral stem. In this research, the new-designed stem(modified collar stem) was considered which made a hole inside stem and had a 3 mm thickness. Using the 3-dimensional finite element methods, the common collar stem and the modified colla stem was modeled and analysed. Also, the two models was compared. The results showed that the modified collar stem decreased the stress-shielding and it made a effective load transfer at the entire femoral region.

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A Study of Osteoporosis Prediction using Morphological Measuring of Proximal Femoral Part and Trabecular Characteristics Based on Femoral Radiographic Image (대퇴부 방사선영상에서 대퇴골 근위부의 형태학적 측정과 골소주의 특성을 이용한 골다공증 예측에 관한 연구)

  • Kim, Sung-Min;Roh, Seung-Gyu;Ro, Yong-Man
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.59 no.4
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    • pp.823-830
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    • 2010
  • This study was designed to examine the morphological measurement and characteristics of trabecullae based on femoral radiographic image for prediction of osteoporosis. Study subjects were 34 females (average age of 62.1 years) and 6 males (average age of 60.1 years), they were categorized into normal group and osteoporosis group in accordance with the T-score value. Measurement of the bone density of femoral bone was measured with DEXA(Dual Energy X-ray absorptiometry). ROI(Region of interests) was selected on femoral neck and trochanter. Characteristics of trabecullae was analyzed by using the skeletonization analysis of trabecular image. Morphological measurement was analyzed through femoral radiographic image in order to examine the correlation with osteoporosis. The result demonstrated statistically significant correlation between neck cortical thickness, shaft width, shaft cortical thickness, periphery, mean gray level and trabeculae area with BMD average (T-score) of femoral part. The results show that morphological measurement and characteristics of trabecullae based on femoral radiographic images for osteoporosis prediction could be effective.

Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Predict of Fracture Risk Rate According to Morphological Measuring of Proximal Femoral Part Using Dual Energy X-ray Absoptiometry (이중에너지 X선 흡수계측법을 이용한 대퇴골 근위부의 형태학적 측정에 따른 골절 위험도의 예측)

  • Yoon, Han-Sik
    • Journal of radiological science and technology
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    • v.25 no.1
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    • pp.49-53
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    • 2002
  • The femoral fracture is the most serious problem of old ages haying osteoporotic fractures. First of all, prevention to reduce the incidence of hip fracture and to identify the risk factor is essential subject. The purpose of this study is to investigate which geometric parameters of proximal femur are related to the hip fracture risk in old ages. Author analyzed the bone density and bone content of over 60 years old women who had suffered hip fracture (n=60) and non fracture groups (n=60). Author concluded that geometric measurements of proximal femoral part made on dual energy x-ray absorptiometry can predict hip fracture independently of bone mineral density.

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Ultrasonographic Finding of Trochanteric Pain after Proximal Femoral Nailing in Patients with Intertrochanteric Fracture - 2 Cases Report - (대퇴 전자간 골절의 근위 대퇴 골수정 삽입술 후 발생한 전자부 통증의 초음파 소견 - 2예 보고 -)

  • Nam, Woo Dong;Han, Kye Young;Cha, Seong Moo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.1
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    • pp.38-41
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    • 2011
  • After closed reduction and internal fixation with proximal femoral nail for intertrochanteric fracture, some patients complained lateral hip pain. We report two cases of lateral hip pain due to tendinopathy confirmed by ultrasonography.

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Anatomic Analysis of Rectus Femoris Functional Flap in Korean (대퇴직근 기능성 유리 피판술을 위한 신경 및 혈관에 대한 해부학적 고찰)

  • Han, Kyoung-Jin;Lee, Young-Kil;Kim, Joon-Yong;Han, Seung-Hwan;Lee, Du-Hyoung;Cho, Jae-Ho
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.1-5
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    • 2007
  • The purpose of this article to evaluate the availability of the rectus femoris flap in Korean subjects. Material and Methods is that Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured the length of the direct head of rectus femoris from anterior superior iliac spine to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal $17.5{\sim}31.4%$ portion of the rectus femoris. The second and the third branch entered at the proximal $22.5{\sim}40.7%$ and $26.3{\sim}42.3%$, respectively. The vessel entry was at $20.2{\sim}37.3%$. The length from ASIS to femoral nerve was $3.5{\sim}8.5\;cm$. Among the 51 rectus femoris muscles, 44 had one nutrient artery, and 7 had 2 nutrient arteries. The nutrient artery originated from the descending branch of the lateral femoral circumflex artery in 18(40.9%) cases, directly from the lateral femoral circumflex artery in 8(18.0%) cases, and from proximal(6 cases, 13.6%) and distal(12 cases, 27.3%) portion of the deep femoral artery. The average length of the nutrient artery was 29.8 mm and the width was 2.14 mm. The point where it meets the main feeding artery of the rectus femoris was $9.0{\sim}15.0\;cm$ from the ASIS. In all cases, the main artery's entrance was proximal to the first nerve branch. Conclusion is that rectus femoris has available data for functional flap.

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