Department of Orthopaedics and Traumatology Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Clinic of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Surg Radiol Anat. 2021 Dec;43(12):2009-2023. doi: 10.1007/s00276-021-02841-3. Epub 2021 Oct 1.
Defining normal anthropometric ranges of proximal femur and femoral head for each age group in children/adolescents is a necessity when differentiating normal anatomical variants from pathological deformities. Aim of this study is to define a set of normal anthropometric parameters based on 3D-CT measurements in normal asymptomatic children/adolescents and analyse the variations arising depending on age, side, and/or gender.
Morphology of the proximal femur was retrospectively assessed in 170 hips (85 children, < 15 years). Measurements included covered femoral head volume (CFHV), femoral head diameter (FHD), femoral head extrusion index (FHEI), coronal alpha angle (CAA), lateral centre-edge angle (LCEA), anterior (AOS) and posterior head-neck offset (POS) and femoral neck-shaft angle (FNSA). Correlation analyses as well as inter- and intra-rater reliability were performed.
CFHV, LCEA, FHD and AOS/POS increased with age and FHEI, CAA, and FNSA decreased with age. None of the measurements correlated with the side. AOS showed a poor correlation with gender. Rapid growth phases were observed at the age of 1, 7 and 11. The inter- and intra-rater reliability was high (range ICC 0.8-0.99 Cronbach alpha 0.86-0.99).
This data delivers a description of growth phases as well as gender and age-correlated reference values of the proximal femoral morphology that could be used by paediatricians and orthopaedic/paediatric surgeons to early diagnose proximal femur deformities and provide guidance in the planning of possible operations.
在区分正常解剖变异与病理性畸形时，定义儿童/青少年每个年龄段股骨近端和股骨头的正常人体测量范围是必要的。本研究旨在根据正常无症状儿童/青少年的 3D-CT 测量值定义一组正常人体测量参数，并分析因年龄、性别和/或侧别而产生的变化。
回顾性评估了 170 髋（85 名儿童，年龄<15 岁）的股骨近端形态。测量包括股骨头覆盖体积（CFHV）、股骨头直径（FHD）、股骨头挤出指数（FHEI）、冠状面 alpha 角（CAA）、外侧中心边缘角（LCEA）、前（AOS）和后股骨头颈偏移（POS）以及股骨颈干角（FNSA）。进行了相关性分析以及组内和组间可靠性分析。
CFHV、LCEA、FHD 和 AOS/POS 随年龄增加而增加，而 FHEI、CAA 和 FNSA 随年龄增加而减少。任何测量均与侧别无关。AOS 与性别相关性较差。在 1 岁、7 岁和 11 岁时观察到快速生长阶段。组内和组间可靠性均较高（ICC 范围 0.8-0.99，Cronbach alpha 0.86-0.99）。
本数据提供了股骨近端形态的生长阶段以及与性别和年龄相关的参考值描述，儿科医生和矫形/儿科外科医生可以使用这些数据来早期诊断股骨近端畸形，并为可能的手术计划提供指导。
