Dimensions of Proximal Femur - An Anatomical Study

 

Gyanaranjan Nayak*

Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, Pin- 751003.

*Corresponding Author E-mail: drgrn82@gmail.com

 

ABSTRACT:

The morphometry of proximal femur is necessary in planning surgeries of hip joint and preparation of prosthesis for hip replacement. The aim of the study was to measure various morphometric parameters of femoral head and neck. The study consisted of sixty adult dry human femora of both sexes (thirty left sided and thirty right sided). Various dimensions of femoral head and neck were measured by slide caliper. Diameter of femoral head was estimated to be 39.28±3.87mm along cranio-caudal axis and 41.18±4.14mm along sagittal axis. Diameter of femoral neck was established as 29.03±3.8mm along cranio-caudal axis and 24.36±3.13mm along sagittal axis. Length of femoral neck was measured to be 50.57±6.77mm. The findings of the study will be useful in manufacturing prosthesis and implants for hip replacement as well as other surgeries involving proximal femur.

 

KEYWORDS: Proximal femur, Morphometry, Hip replacement, Implant, Prosthesis.

 

 

INTRODUCTION:

The femur is the longest bone of human body. The proximal part of femur is contributed by the head, anatomical neck joining the head with the trochanters, greater and lesser trochanters and the surgical neck joining the diaphysis with proximal epiphysis of femur1. The femur is a major weight bearing bone and provides attachment to various muscles of thigh. The knowledge about the morphometric parameters of proximal femur is necessary to ward off various complications resulting from surgeries of proximal femur and for alignment of prosthesis to be implanted2.

 

Surgeries of the proximal femur are very common orthopaedic procedures for restoring normal morphology and treating surgical pathology. The dimensions of head and neck of femur are useful in determining stature and sex in anthropology and forensic medicine3.

 

As the morphometric parameters of proximal femur are of paramount importance in orthopaedic surgery, anthropology and forensic medicine4 we undertook the current study to do morphometric analysis of femoral head and neck.

 

MATERIAL AND METHODS:

The descriptive study was conducted with sixty adult human femora of either sex (thirty right sided and thirty left sided) used for teaching routine osteology to undergraduate MBBS students. Broken and deformed femora with obvious pathology were excluded from the study. The following parameters were measured using slide caliper-

(a)  Diameter of femoral head in cranio-caudal axis5 (Figure 1)

(b)  Diameter of femoral head in sagittal axis5 (Figure 2)

(c)  Diameter of femoral neck in cranio-caudal axis5 (Figure 3)

(d)  Diameter of femoral neck in sagittal axis5 (Figure 4)

(e)  Length of neck of femur- Distance between the inferior region of base of femoral head and lower end of intertrochanteric line6 (Figure 5)

 

 

Fig 1: Figure showing measurement of diameter of femoral head in cranio-caudal axis with slide caliper.

                                                           

Fig 2: Figure showing measurement of diameter of femoral head in sagittal axis with slide caliper.

Fig 3: Figure showing measurement of diameter of femoral neck in cranio-caudal axis with slide caliper.

 

                                                              

Fig 4: Figure showing measurement of diameter of femoral neck in sagittal axis with slide caliper.

Fig 5: Figure showing length of neck of femur from inferior region of base of femoral head (A) to lower end of intertrochanteric line (B)

 

Statistics:

The data was tabulated and analysed using Microsoft Excel software. Unpaired t test was applied and P value < 0.05 was taken as significant. Pearson coefficient          (r value) was also calculated.

 

RESULTS:

The results are depicted in Table 1.

 

Table 1: Different parameters of femoral head and neck.

Parameter

Left side (n=30)

Right side (n=30)

Both sides (n=60)

P value

r value

DFH CCA

39.05±3.31 mm

39.5±4.49 mm

39.28±3.87 mm

0.75

-0.11

DFH SA

41±3.73 mm

41.26±4.65 mm

41.84±4.14 mm

0.92

-0.08

DFN CCA

29.58±3.15 mm

28.48±4.4 mm

29.03±3.8 mm

0.43

-0.1

DFN SA

24.31±2.43 mm

24.41±3.79 mm

24.36±3.13 mm

0.93

-0.39

LFN

50.3±6.77 mm

50.85±7 mm

50.57±6.77 mm

0.82

-0.03

 

DFH CCA- Diameter of femoral head in cranio-caudal axis, DFH SA- Diameter of femoral head in sagittal axis, DFN CCA- Diameter of femoral neck in cranio-caudal axis, DFN SA- Diameter of femoral neck in sagittal axis, LFN- Length of femoral neck.

 

Diameter of femoral head along cranio-caudal axis was more in right sided femora. Diameter of femoral head along sagittal axis was more in right sided femora. Diameter of femoral neck along cranio-caudal axis was more on left side. Diameter of femoral neck in sagittal axis was more on right side. Length of femoral neck was more on right side. However these differences were not found to be statistically significant. Pearson coefficient (r value) obtained for different parameters did not show much correlation between left and right sides.

 

DISCUSSION:

Various other studies have demonstrated different parameters of femoral head and neck.

 

 

Menezes et al5 have reported following values- diameter of femoral head along cranio-caudal axis- 4.42±0.44 cm; diameter of femoral head along sagittal axis- 4.38± 0.47cm; diameter of femoral neck along cranio-caudal axis- 3.1±0.35cm; diameter of femoral neck along sagittal axis- 2.5±0.37cm; length of femoral neck- 2.55± 0.42cm.

 

Verma et al6 have obtained following values in Indian population- femoral head diameter- 42.32±4.11 mm; femoral neck length- 44.75±8mm; femoral neck diameter- 33.02±4.22 mm; femoral neck thickness 24.01 ±3mm.

 

Findings of other authors are depicted in Table 2.

Table 2: Comparison of linear measurements of other authors.

Authors

Population

Diameter of femoral head(mm)

Width of femoral neck(mm)

Length of femoral neck(mm)

Sousa et al7

Brazil

46.56±3.6

30.96±2.94

30.4±4.18

Mourao and Vasconcellos1

Brazil

-

Right-26.7±3.1

Left- 26.3±3.3

Right-24.9±4.5

Left-24.3±4.2

Hoaglund and Low8

China

45

31

-

Dutchie et al9

Scotland

Male- 50.2±0.6

Female- 45.2±0.6

Male-35.8±0.6

Female- 32.1±0.4

Male-32.5±0.9

Female-35±0.7

Igbibi and Msamati10

Malaysia

-

Right-26.7±3.1

Left-26.3±3,3

Right-24.9±4.5

Left-24.3±4.2

 

The differences between values obtained by various authors can be attributed to racial and geographic differences.

 

CONCLUSION:

The values of the various morphometric parameters of proximal femur are starkly different for Indian population (obtained in our study) when compared to European and American studies. So the current study will be of immense value for designing the concerned prosthesis for Indian subjects.

 

CONFLICTS OF INTEREST:

The authors declare no conflicts of interest.

 

REFERENCES:

1.      Mourao AL, Vasconcellos HA. Geometria do femur proximal em ossos de brasileiros. Acta Fisiatrica. 2001;8(3): 113-119.

2.      Mahaisavariya B, Sitthiseripratap K, Tongdee T. Morphological study of proximal femur: a new method of geometrical assessment using 3-dimensional reverse engineering. Med Engineering and Physics.2002;24(9): 617-622.

3.      Khan SM, Saheb SH. Study on neck shaft angle and femoral length of South Indian femur. International Journal of Anatomy and Research.2014;2: 633-635.

4.      Chaudhary PN, Shirol VS, Virupaxi RD. A morphometric study of femoral length, anterior neck length and neck-shaft angle in dry femora; A cross-sectional study. Indian Journal of Health Sciences and Biomedical Research. 2017 Sept- Dec;10(3): 331-334.

5.      Menezes TM, Rocha TDS, Oliviora BDR et al. Proximal femoral epiphysis: manual morphometry versus digital morphometry. Intrnational Journal of Morphology. 2015;33(3): 1114-1119.

6.      Verma M, Joshi S, Tuli A et al. Morphometry of proximal femur in Indian population. Journal of Clinical and Diagnostic Research. 2017 Feb;11(2): AC 01-AC 04.

7.      Sousa EB, Fernades RMP, Mathias MB et al. Morphometric study of the proximal femur extremity in Brazilians. International Journal of Morphology.2010;28(3): 835-840.

8.      Hoagulund FT, Low WD. Anatomy of the femoral neck and head with comparative data from Caucasians and Hong Kong Chinese. Clinical Orthopedic Related Research.1980;152: 10-16.

9.      Dutchie RA, Bruce MF, Hutchison JD. Changing proximal femoral geometry in north east Scotland: an osteometric study. British Medical Journal.1998;316:1498.

10.   Igbibi PS and Msamati BC. The femoral collodiaphysial angle in Malawian adults. American Journal of Orthopedics.2002;31(12): 682-685.

 

 

 

 

Received on 10.04.2020           Modified on 25.06.2020

Accepted on 18.07.2020         © RJPT All right reserved

Research J. Pharm. and Tech. 2021; 14(5):2540-2542.

DOI: 10.52711/0974-360X.2021.00447