Maehara Takashi, Kiyono Masahiro, Noda Tomoyuki, Sato Ryozo, Kadota Hiroaki, Hori Tadahiro, Koga Yoichi, Hidaka Yoshihisa, Joko Ryoji, Muraoka Sosuke, Ozaki Toshifumi
1 Department of Orthopaedic Surgery, Kagawa Rosai Hospital, Kagawa, Japan.
2 Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.
J Orthop Surg (Hong Kong). 2019 Jan-Apr;27(1):2309499018816488. doi: 10.1177/2309499018816488.
While various implants are currently used for the treatment of femoral trochanteric fractures in Japan, 'mismatches' have been known to occur between patient and implant type. The purpose of this study is to identify morphological characteristics of elderly Japanese females, both in terms of the shape of proximal femur and its anterior curvature in order to evaluate the suitability of implants for treatment of femoral trochanteric fractures using 3D-computed tomography (CT) scanning.
This study used CT scan data taken from 50 elderly females (aged 70 years or older). Neck-shaft (NS) angle and height of the greater trochanter (GT) were measured under defined conditions (TPI: theoretical plane to place implant). Anterior curvature of the femoral shaft was also measured.
On average, the NS angle was found to be 128.1° and GT height was 62.4 mm. Average curvature radius was 1040 mm. As for the NS angle, the centrum-collum-diaphysis angles of existing implants (125° or 130°) are reasonable. In elderly Japanese patients, the proximal femur shows specific characteristics. As GT height is very short, the implant may easily interfere with the lateral cortex. Additionally, the curvature radius calculated (1040 mm) was smaller than that of past reports, indicating strong curvature in the Japanese elderly.
Our measurement results are potentially useful in the avoidance of intraoperative trouble caused by mismatch of implants.
在日本,目前虽有多种植入物用于治疗股骨转子间骨折,但已知患者与植入物类型之间会出现“不匹配”情况。本研究的目的是确定日本老年女性的形态特征,包括股骨近端的形状及其前曲率,以便使用三维计算机断层扫描(CT)来评估植入物治疗股骨转子间骨折的适用性。
本研究使用了从50名老年女性(70岁及以上)获取的CT扫描数据。在规定条件下(TPI:放置植入物的理论平面)测量颈干(NS)角和大转子(GT)的高度。还测量了股骨干的前曲率。
平均而言,NS角为128.1°,GT高度为62.4毫米。平均曲率半径为1040毫米。至于NS角,现有植入物的中心-颈-骨干角(125°或130°)是合理的。在日本老年患者中,股骨近端表现出特定特征。由于GT高度非常短,植入物可能容易干扰外侧皮质。此外,计算得出的曲率半径(1040毫米)小于过去的报告,表明日本老年人的曲率较大。
我们的测量结果可能有助于避免因植入物不匹配而导致的术中问题。