Trauma Department, Hannover Medical School, Hannover, Germany.
J Orthop Trauma. 2011 Sep;25(9):549-55. doi: 10.1097/BOT.0b013e3181f9eeac.
To describe a new method for femoral rotational alignment during intramedullary nail insertion using the profile of the greater trochanter and its relation to the femoral head.
Radiologically, the line that represents the posterior border of the greater trochanter comes in contact with the femoral head contour during external rotation. The degree of rotation to achieve this contact was measured on both lower extremities of 15 whole fresh-frozen cadavers and seven dried human femora using a standard image intensifier. Computed tomography was used in the dried femora to assess the femoral anteversion angle, the length of the femoral neck, and the neck-shaft angle.
The side difference of the greater trochanter-head contact angle was 6° or less in 14 of 15 whole fresh-frozen cadavers. Regarding the dried human femora, this angle had a strong positive correlation with femoral neck anteversion angle (r = 0.9), whereas no statistically significant correlation could be detected with the neck length or the neck-shaft angle.
Our described method is simple to execute because it depends on a definite point of measurement. Furthermore, an angle is recorded for each extremity, which enables us to estimate the amount of the rotational difference. This method does not depend on special views, especially at the hip, but only a direct anteroposterior view with gradual internal rotation of the image intensifier.
描述一种使用大转子轮廓及其与股骨头关系来进行髓内钉插入时股骨旋转对线的新方法。
在放射学上，代表大转子后缘的线在外旋时与股骨头轮廓接触。使用标准影像增强器在 15 具全冷冻新鲜尸体和 7 具干人股骨的双侧下肢测量实现这种接触的旋转程度。在干股骨中使用计算机断层扫描评估股骨前倾角、股骨颈长度和颈干角。
在 15 具全冷冻新鲜尸体中，14 具的大转子-头接触角的侧方差异为 6°或更小。对于干人股骨，该角度与股骨颈前倾角呈强正相关（r = 0.9），而与颈长或颈干角无统计学显著相关性。
我们描述的方法很简单，因为它依赖于一个明确的测量点。此外，为每侧肢体记录一个角度，这使我们能够估计旋转差异的程度。这种方法不依赖于特殊的视图，尤其是髋关节，而仅依赖于直接前后位并逐渐内旋影像增强器。
