Immediately lateral to the head is the neck that connects the head with the shaft. The proximal femur is the most important site of osteoporotic fracture. The anatomy of the region is important when considering fractures of the proximal femur. To evaluate the correlation between radiographic parameters of the proximal femur anatomy and fractures. We discuss the normal anatomy of the proximal femur and nonmetric variations of the femoral head asphericity, headneck junction pistolgrip deformity, lateral flatening, anterior neck poiriers facet, reaction area, capsular ridge, allens fossa. Anatomic reduction anatomic plate profile assists reduction of the metaphysis. The morphology of the proximal femur has been extensively studied in the adult population. The aim of this study was to propose the concept of different anatomical axes for the proximal and distal parts of the femur.
Evaluation of proximal femoral geometry using digital photographs. Blood supply for the femoral head is derived from vessels within the hip capsule. The femur is the longest, heaviest, and strongest bone in the human body. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. A guide to the placement of this mark is the linea aspera on the posterior aspect of the femur. Studies on prosthesis positioning and implant design in total hip arthroplasty tha have generally focused on the anatomy of the. Note based on patient anatomy and plate position, not all proximal screw options may. Anatomy of the hip university of the west of england, bristol. Anatomy, bony pelvis and lower limb, femur statpearls ncbi. There is considerable variation in the anatomy of the proximal femur. Restoration of proximal femoral anatomy during total hip.
The two basal segments preceding the femur are the coxa and trochanter. When a fracture of the femoral neck occurs, disruption to these blood vessels can occur result in devascularisation of the femoral head and resulting avascular necrosis. An extensive vocabulary has been developed to describe the anatomy of the proximal femur, ranging from length measurements like femoral head diameter. Characterization of proximal femoral anatomy in the skeletally. Pelvic girdle, sacrum, and proximal femur pelvic girdle fractures involving the structures of the pelvic girdle, which are usually sustained in motor vehicle accidents or falls from heights, represent only a small percentage of all skeletal injuries. Aug 29, 2008 the purpose of our study, therefore, was to combine the existing measurements of the proximal femur or modifications and expansions of these measures as necessary with an original measure of femoral head rotation to create a complete description of the proximal femurs anatomy and use this devised framework to produce a global assessment of. Fractures of the proximal femur involving the neck and trochanters are quite common.
The proximal femur is an area of predilection for many bone tumors, both benign and malignant. The evolution of the blood supply to the femoral head and proximal femur depends largely on the development of the growth plates and growth of femoral neck and greater trochanter. The vascular anatomy of the proximal femur plays a key role in determining the optimal treatment modality, such that fracture classification and reporting should address the likelihood of vascular compromise. Normal anatomy and variations of the proximal femur. The human femur can resist forces of 1,800 to 2,500 pounds, so it is not easily fractured. Intertrochanteric osteotomy ito is the most established hipjointpreserving procedure. The femur os femoris extends from the hip to the knee and is the longest and strongest bone in the body. Pdf surgically relevant bony and soft tissue anatomy of the. The femur consists of a shaft body and superior or proximal and inferior or distal end. Pdf orthopaedic aspect of anatomy and radiology of proximal femur.
Distal femur lecture orthopaedic trauma association. Its length varies from onefourth to onethird of that of the body. With an intermediate segmental and additional wedge fragments 42c2. Jan 31, 2018 the anatomical axis of the femur is crucial for determining the correct alignment in corrective osteotomies of the knee, total knee arthroplasty tka, and retrograde and antegrade femoral intramedullary nailing imn. Surgically relevant bony and soft tissue anatomy of the. Characterization of proximal femoral anatomy in the. Gmrs proximal femoral surgical protocol 2 marking anterior aspect of femur a longitudinal line representing the anterior point on the femur should now be marked distal to the resection level to aid in rotational orientation of the prosthesis figure 2. Round, smooth proximal portion of the femur that articulates with the hip bone neck a strong pyramidal process of bone that connect the head with the shaft in the region of the trochanters. Surgically relevant bony and soft tissue anatomy of the proximal femur article pdf available in the orthopaedic journal of sports medicine 26 june 2014 with 7,795 reads how we measure reads. Proximal femoral fractures radiology reference article. The main function of the femur is to transmit forces from the tibia to the hip joint. Introduce the awl into the proximal femur at the designated entry point until it is below the level of the lesser trochanter. Pdf surgically relevant bony and soft tissue anatomy of.
The usage is not homologous with that of vertebrate anatomy. It acts as the site of origin and attachment of many muscles and ligaments, and can be divided into three parts. Request pdf on apr 6, 2014, martin beck and others published anatomy of the proximal femur find, read and cite all the research you need on researchgate. The incidence of hip fracture rises exponentially in men with aging, as it does in women. The femoral head projects medially and superiorly and articulates with the acetabulum of the pelvis to form the hip joint. Learn femur bones anatomy physiology with free interactive flashcards. Definition of a novel proximal femur classification in the sagittal. In this article, we shall look at the anatomy of the femur its attachments, bony landmarks and clinical correlations. The following paragraph summarizes the few publications on the blood supply of the growing proximal femur 29,30,31,32,33. Through studying the anatomy of the hip, the student can relate hip structures to hip function and apply this knowledge and understanding in health and to pathology and deformities.
Femur the femur is the longest and heaviest bone in the body. Apr 02, 2015 the human femur can resist forces of 1,800 to 2,500 pounds, so it is not easily fractured. The femur, which is the longest bone in the body helps contribute to the extensive stride length of human gait figs. However, the age at which the increase begins is slightly older. Proximal femoral fractures rsna publications online. The femur is classed as a long bone, only bone in the thigh, and the longest bone in the body. Calais germain b 1993 anatomy of movement seattle, eastland press palastanga n, field d, soames r 2006 anatomy. The proximal femur undergoes significant developmental changes in utero and until puberty. The proximal portion of each femur is composed of a head, a neck, and a shaft. This publication is not intended for distribution in the usa.
A break in this bone can only result from a large amount of force, such as a car accident or a fall from. The head of the femur contains a small, cuplike depression called the fovea, which accepts the ligamentum teres. The proximal femur has historically been the site of choice for the realignment of the hip. Pdf proximal femoral anatomy of australopithecus owen. Choose from 500 different sets of femur bones anatomy physiology flashcards on quizlet. At birth the femoral shaft is an ossified tube with enlarged proximal and distal cartilaginous ends. Pdf femoral pathology is common in relation to the orthopedic. Proximal femoral anatomy in the normal human population. The femur is the only bone in the thigh and the longest bone in the body. The vascular anatomy of the proximal femur plays a key role in determining the optimal treat ment modality, such that fracture classification and. Forming the midportion of the femur is a long cylindrical shaft, which arches or curves anteriorly. Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area. To ascertain the geometry of the femur in the brazilian. Measure the proximal femur and make a reference resection mark and a rotation mark with either methylene blue or a cautery device figure 2.
An original technique kerong wu, md, xianzuo zhang, md, min chen, md, xifu shang, md, phd department of orthopedics, the first af. A retrospective study was performed in a series of 24 patients 26 hips with crowe iiiiv. For intramedullary fixation of proximal femur fractures. Anatomical axes of the proximal and distal halves of the. A firm grasp of the anatomy of the proximal femur is required as a foundation to understand the treatment principles for fractures of this specific anatomical structure.
Three hundred and five digital xrays of the pelvis were analyzed in the anteroposterior view. Villar, in techniques in hip arthroscopy and joint preservation surgery, 2011. May 22, 2016 the evolution of the blood supply to the femoral head and proximal femur depends largely on the development of the growth plates and growth of femoral neck and greater trochanter. Anatomy of the proximal femur, hips, and pelvis flashcards. Anatomy distal femur femur transitions from cylinder to condyles medial condyle extends further inferior cancellous bone trapezoidal shape what this means for fixation avoid notch and concomitant injury to cruciate ligaments avoid penetration of medial cortex with anterior screws x x deforming forces quadriceps. There is complex anatomy of the proximal femur and hip joint. Feb 19, 2020 to introduce a modified osteotomy method for proximal femur reconstruction pfr in total hip arthroplasty tha for high developmental dysplasia of the hip ddh. Pdf linear and angular measurements were made on thirtytwo cadaveric femora with respect to the mechanical functional axes of the bone. Radiographic study on the anatomical characteristics of the proximal femur in brazilian adults. Proximal third closer to the head or cranial end of the body 4.
The current study aims to characterize such anatomy in. Proximal definition of proximal by the free dictionary. Restoration of proximal femoral anatomy during total hip arthroplasty for high developmental dysplasia of the hip. The intramedullary lesions in this region can have many overlapping findings with regard to their. The anterior surface of the femur with parts labeled. Proximal third closer to the head or cranial end of the body middle third 5.
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