Shi Tianhao, Jia Xiaoyang, Zhang Kun, Jia Gengxin, Yang Zhenqi, Qiang Minfei, Chen Yanxi
Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.
BMC Musculoskelet Disord. 2025 Apr 5;26(1):337. doi: 10.1186/s12891-025-08588-x.
The lateral femoral wall is an important anatomical parameter of the proximal femur, but intramedullary nail fixation for intertrochanteric fractures may cause iatrogenic lateral wall fractures due to population-based design differences. This study aims to measure the anatomical parameters of the proximal femoral medullary cavity and provide data to help design intramedullary nails tailored to the Chinese population to reduce the risk of complications such as lateral wall fractures.
Consecutive patients undergoing full-length or upper half CT scans of the femur were included from January 2010 to December 2021. The anatomical parameters of medullary cavity were defined and measured, including prominence length, canal-shaft angle and proximal minimum diameter. Intraclass Correlation Coefficient (ICC) was used to estimate the inter- and intra-observer agreements.
A total of 168 patients, comprising 78 men and 90 women, were included. The mean prominence length was 67.4 ± 4.9 mm (males: 70.8 ± 3.6 mm, females: 64.4 ± 3.9 mm). The mean canal-shaft angle was 5.5° ± 0.7° (males: 5.6 ± 0.8°, females: 5.5 ± 0.7°). The mean proximal minimum diameter was 22.7 ± 1.8 mm (males: 24.0 ± 1.5 mm, females: 21.6 ± 1.4 mm) at the level of 1/3 prominence length from bottom to top. Gender differences were observed in these parameters (p < 0.001) except for the canal-shaft angle (p = 0.45). The mean proximal minimum diameter was significantly larger in the group aged 50 years and older (23.1 ± 1.7 mm) compared to the group younger than 50 years (22.4 ± 1.9 mm) (p = 0.02). Inter- and intra-observer agreement was almost perfect for all the parameters (all ICC values > 0.8).
Males have a longer prominence length and larger proximal minimum diameter than females. The proximal minimum diameter is larger in the older population than in the younger population. The measurement results help support the design of intramedullary nails tailored to the Chinese population.
Not applicable.
股骨外侧壁是股骨近端的一个重要解剖参数，但由于基于人群的设计差异，股骨转子间骨折的髓内钉固定可能导致医源性外侧壁骨折。本研究旨在测量股骨近端髓腔的解剖参数，并提供数据以帮助设计适合中国人群的髓内钉，从而降低诸如外侧壁骨折等并发症的风险。
纳入2010年1月至2021年12月期间接受股骨全长或上半段CT扫描的连续患者。定义并测量髓腔的解剖参数，包括突出长度、髓腔-骨干角和近端最小直径。采用组内相关系数（ICC）评估观察者间和观察者内的一致性。
共纳入168例患者，其中男性78例，女性90例。平均突出长度为67.4±4.9mm（男性：70.8±3.6mm，女性：64.4±3.9mm）。平均髓腔-骨干角为5.5°±0.7°（男性：5.6±0.8°，女性：5.5±0.7°）。在从底部向上1/3突出长度水平处，平均近端最小直径为22.7±1.8mm（男性：24.0±1.5mm，女性：21.6±1.4mm）。除髓腔-骨干角外（p=0.45），这些参数存在性别差异（p<0.001）。50岁及以上组的平均近端最小直径（23.1±1.7mm）显著大于50岁以下组（22.4±1.9mm）（p=0.02）。所有参数的观察者间和观察者内一致性几乎完美（所有ICC值>0.8）。
男性的突出长度比女性长，近端最小直径比女性大。老年人群的近端最小直径比年轻人群大。测量结果有助于支持适合中国人群的髓内钉设计。
不适用。
