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Predicting proximal femur rotation by morphological analyses using translucent 3-dimensional computed tomography

Authors
 Chang Dong Han  ;  Young Han Lee  ;  Kyu Hyun Yang  ;  Ick Hwan Yang  ;  Woo Suk Lee  ;  Yoo Jung Park  ;  Kwan Kyu Park 
Citation
 ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, Vol.132(12) : 1747-1752, 2012 
Journal Title
 ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 
ISSN
 0936-8051 
Issue Date
2012
MeSH
Aged ; Female ; Femur/anatomy & histology* ; Femur/diagnostic imaging* ; Hip Joint/anatomy & histology* ; Hip Joint/diagnostic imaging* ; Humans ; Imaging, Three-Dimensional* ; Male ; Middle Aged ; Predictive Value of Tests ; Range of Motion, Articular* ; Retrospective Studies ; Rotation ; Tomography, X-Ray Computed/methods*
Keywords
Femur ; Rotation ; Translucent 3D CT ; GT ratio ; LT ratio ; Trochanter method
Abstract
BACKGROUND: Predicting rotation of proximal femur in femur fracture surgeries is important to prevent malrotation. OBJECTIVE: We aimed to prevent malrotation by developing a simple guideline that enables the prediction of proximal femur rotation using translucent 3-dimensional computed tomography (3D CT). DESIGN: Retrospective. SETTING: One tertiary general hospital in the Republic of Korea. PATIENTS: Thirty-six subjects who underwent CT angiographies for vascular evaluation. INTERVENTION: Translucent 3D CT images were created from the CT data. MAIN OUTCOME MEASURE: Morphologic ratios of the great trochanter (GT) and lesser trochanter (LT) with the hip center as a basic point were measured at neutral position and at 5°, 10°, 15°, 20°, 25°, and 30° of internal rotation (IR) and external rotation (ER). The rotation angles at which the GT ratio becomes 0.5 and 0.33 and the rotation angles at which the LT ratio becomes 0.0 and 1.0 were determined to serve as guide angles. RESULTS: Both the proportion of GT and LT compared with proximal femur with hip center as a reference (GT and LT ratio) gradually increased in the shift from IR to ER. At a neutral position, the GT and LT ratios were approximately 0.4 and 0.5, respectively. At 10°-15° of ER, the approximate GT and LT ratios were 0.5 and 1.0, respectively. At 30° of ER, the GT ratio exceeded 0.6, and the LT ratio exceeded 1.0. Between 10° and 15° of IR, the GT ratio decreased to approximately 0.33 and the LT ratio decreased to 0.0, which indicated that the LT was invisible. CONCLUSIONS: We suggested practical values which might be useful as a reference in the operating room practically and hope that our findings would be helpful to prevent malrotation while performing proximal femur or femur shaft surgeries.
Full Text
http://link.springer.com/article/10.1007%2Fs00402-012-1609-1
DOI
23001351
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Yang, Ick Hwan(양익환)
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
Lee, Woo Suk(이우석) ORCID logo https://orcid.org/0000-0002-0798-1660
Han, Chang Dong(한창동)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89619
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