The Correlation Analysis Of Proximal Femoral Anatomy Parameters Measurement And Proximal Femoral Intramedullary Nail

Objectives:To measure and analyze the proximal femur anatomical parameters of southernpopulations in Hunan province by three-dimentional reconstruction for providinganatomical datas to design proximal femoral intramedullary nail that meet themorphological characteristics of Chinese and providing reference to selectpreoperative intramedullary internal fixation for clinicians.Materals and methods:We selected160adult patients of340cases who do the hip joint ComputedTomography examination from February2012to January2013. There are78cases offeale and82cases of male, with an average age of57.4(22-82) years and an averageheight of160.9(140.5-178.5) cm. The cases with trauma and lesions of the side of thefemur were excluded from selected samples. CT datas were stored in DICOM formatand imported MIMICS10.01. The study-related parameters were measured afterthree-dimensional reconstruction by MIMICS10.01. These parameters were containedthe femoral head diameter(a), the femoral long diameter(b), the femoral neckminimum vertical diameter(c), the lengths of femoral neck in125°,130°and135°under,middle and upper of edge of femoral neck(d1、d2、d3、e1、e2、e3、f1、f2、f3), thedistance between the greater trochanter vertices to the intersection of the middle of theneck axis and femoral shaft axis(h), the length of projection of h in the level of theproximal femoral shaft axis(g), neck shaft angle(α). We compared our experimentaldatas with the datas at home and abroad and analyzed the statistical diferences of parameters between female and male. At the same time, the correlations between theparameters and height, age were analyzed by the method of simple correlationanalysis.Results:1. The results of study-related parameters: the femoral head diameter is44.29±3.27mm, the femoral long diameter is36.94±4.98mm, the femoral neckminimum vertical diameter is30.76±3.14mm, the lengths of femoral neck in125°,130°and135°under, middle and upper of edge of femoral neck are85.91±6.13mm,86.17±5.92mm,78.90±5.86mm,90.40±6.74mm,87.51±5.88mm,77.96±5.31mm,95.87±6.70mm,90.91±5.88mm,80.94±5.22mm respectively. thedistance between the greater trochanter vertex to the intersection of the middle of theneck axis and femoral shaft axis is32.06±2.30mm, the length of projection of h in thelevel of the proximal femoral shaft axis is29.73±2.51mm, neck shaft angle(α) is(128.30±6.12)°.2. In addition to the neck shaft angle(ɑ), closer to the averagenumber is relatively constant, the datas of remaining parameters fit the normaldistribution. There were no statistically significant differences in femoral headdiameter(a) and neck shaft angle(ɑ) between our stud and Lu QY’, Wang Y’.Compared with the datas of Noble PC and Massin P, the femoral head diameter showssmaller and the neck shaft angle shows larger in our study.3. In addition to the neckshaft angle showed no statistically significant difference in women and men group,there was significant differences in the rest of parameters between the two groups.There was no statistically significant differences among age groups using analysisvariance.4. The correlation analysis between parameters and gender, age, height: Inaddition to the neck shaft angle has no correlation with height, the rest parameterswere positively correlated with the height by method of simple correlation analysis,while all parameters have no correlation with age.Conclusions:1.In addition to the neck shaft angle has no correlation with height, the restparameters were positively correlated with the height by method of simple correlation analysis, while all parameters have no correlation with age.2. Most of parametersshow differences between female group and male group, but not the neck shaft angle.3. The length of projection of h(the distance between the greater trochanter vertices tothe intersection of the middle of the neck axis and femoral shaft axis) in the level ofthe proximal femoral shaft axis(g) was highly positively correlated with the height.The95%confidence interval is29.34mm-30.12mm. To avoid the upper end ofproximal femur anti-rotation intramedullary nail often highlight the greater trochanterso excessive that cause postoperative long-time hip pain, especially the diminutiveAsian older women, and the distance between the top of the nail to the inside of thetop of the spiral blade hole should be shorter.