Newell R L
School of Molecular and Medical Bioscience, University of Wales, Cardiff, United Kingdom.
Clin Anat. 1997;10(1):27-33. doi: 10.1002/(SICI)1098-2353(1997)10:1<27::AID-CA5>3.0.CO;2-Q.
The term calcar femorale (originally referring to a bony spur projecting into the cancellous tissue of the base of the femoral neck) differs from most anatomical terms in that it has developed separate meanings in different areas of use. In particular, its present meaning for most orthopedic surgeons differs from its classical anatomical significance. This work shows that the classical, "textbook" anatomical interpretation-usually attributed to Merkel (1874, cited by Harty, 1957, J. Bone Joint Surg. [Am.] 39:625-630)-is not entirely correct, being based on an incomplete appreciation of the true nature of the three-dimensional structure of the upper end of the femur. Though Humphry (1858, A Treatise on the Human Skeleton, Cambridge, England: Macmillan) was aware of the importance of the third dimension, it was the largely neglected work of Dixon (1910, J. Anat. Physiol., 44:223-230), itself published to draw attention to the ideas of Krause (1909, in Bardeleben's Handbuch der Anatomie des Menschen, Jena: Gustav Fischer), which indicated the true nature of the calcar femorale and the limitations of Merkel's view. Dixon's work has been developed and consolidated by others such as Garden (1961, J. Bone Joint Surg. [Br.] 43:576-589), who was apparently unaware of Dixon, just as Dixon himself appears to have been unaware of the work of Bigelow (1875, published in Bigelow, 1900, The Mechanisms of Dislocations and Fracture of the Hip, Boston: Little, Brown), which pre-empted one of his major concepts. Even earlier work by Bigelow (1869, published in Bigelow; 1900, The Mechanisms of Dislocations and Fracture of the Hip, Boston: Little, Brown) appears to have pre-empted that of Merkel. The adoption of the three-dimensional, "Dixon concept" of the bony anatomy of the upper end of the femur leads to an entirely different set of structural engineering analogies from those two-dimensional ones which have become commonplace since the work of Ward (1838, cited by Garden, 1961, J. Bone Joint Surg. [Br.] 43:576-589) and Wolff (1870, cited by Keith, 1919, Menders of the Maimed, London: Frowde and Hodder & Stoughton).
股骨距这一术语（最初指的是向股骨颈基部松质组织内突出的骨嵴）与大多数解剖学术语不同，因为它在不同的应用领域产生了不同的含义。特别是，它目前对于大多数骨科医生的意义与其经典解剖学意义有所不同。这项研究表明，经典的、“教科书式”的解剖学解释——通常归功于默克尔（1874年，哈蒂引用，1957年，《骨与关节外科杂志》[美国]39:625 - 630）——并不完全正确，它基于对股骨上端三维结构真实本质的不完全理解。尽管汉弗莱（1858年，《人体骨骼论》，英国剑桥：麦克米伦）已经意识到三维的重要性，但迪克森（1910年，《解剖学与生理学杂志》，44:223 - 230）的研究在很大程度上被忽视了，迪克森的研究本身是为了引起人们对克劳斯（1909年，载于巴尔德勒本的《人体解剖学手册》，耶拿：古斯塔夫·费舍尔）观点的关注，该研究指出了股骨距的真实本质以及默克尔观点的局限性。迪克森的研究由其他人如加登（1961年，《骨与关节外科杂志》[英国]43:576 - 589）进一步发展和巩固，加登显然不知道迪克森的研究，就像迪克森本人似乎也不知道比奇洛（1875年，发表于比奇洛1900年的《髋关节脱位与骨折的机制》，波士顿：利特尔·布朗）的研究一样，比奇洛的研究抢先提出了他的一个主要概念。甚至比奇洛更早的研究（1869年，发表于比奇洛1900年的《髋关节脱位与骨折的机制》，波士顿：利特尔·布朗）似乎也抢先于默克尔的研究。采用股骨上端骨解剖学的三维“迪克森概念”会导致与自沃德（1838年，加登引用，1961年，《骨与关节外科杂志》[英国]43:576 - 589）和沃尔夫（1870年，基思引用，1919年，《伤残修复者》，伦敦：弗罗德与霍德&斯托顿）的研究以来变得常见的二维结构工程类比完全不同的一组类比。
