The comparison of femoral curves and curves of contemporary intramedullary nails

The aim of this study was to evaluate both the cortical and the medullary anterior bowing of the femur, and to compare these measurements with current intramedullary nails to assess the adequacy of their design. Methods: Lateral digital radiographic views of left femurs of 104 normal subjects (18–68 years old) were obtained. Radii of cortical and medullary curvatures of femurs were calculated using these images. The values obtained were compared to the radius of curvatures of ten different intramedullary nails. Results: Medullary bowing was between 114 and 1,389 mm (mean: 722 mm, SD: 230 mm) and the cortical bowing was between 109 and 1,666 mm (mean: 770 mm, SD: 267 mm). For males, these values were 114–1,389 mm (mean: 722 mm, SD: 230 mm) and 109–1,666 mm (mean: 770 mm, SD: 267 mm), respectively. For females, they were 114–1,389 mm (mean: 722 mm, SD: 230 mm) and 109–1,666 mm (mean: 770 mm, SD: 267 mm), respectively. The differences between genders were not significant. Cortical and medullar bowing was strongly correlated with age (r=−0.269, p<0.006 and r=−0.234, p<0.017, respectively). These significances were produced by females only. Radii of curvatures of intramedullary nails ranged between 150 and 300 cm and were higher than the mean cortical (77 cm) and medullary (72.2 cm) bowings. Conclusion: The difference between the curves of femur and the contemporary femoral nails implicates the inadequacy of the design of such nails for the Caucasian race living in Anatolia. Therefore, such nails should be revised accordingly to prevent the above-mentioned complications.

[1]  P. Procter,et al.  Geometric Mismatch of the Gamma Nail to the Chinese Femur , 1996, Clinical orthopaedics and related research.

[2]  C. Heyde,et al.  Ultrasonographic imaging of fractures of the clavicle in newborn infants. , 2003, The Journal of bone and joint surgery. British volume.

[3]  Michael A. Mont,et al.  Anthropometric Measurements of the Human Knee: Correlation to the Sizing of Current Knee Arthroplasty Systems , 2003, The Journal of bone and joint surgery. American volume.

[4]  G. Gill,et al.  Racial variation in the proximal and distal femur: heritability and forensic utility. , 2001, Journal of forensic sciences.

[5]  R. Sanders,et al.  Angular Malalignment After Intramedullary Nailing of Femoral Shaft Fractures , 2001, Journal of orthopaedic trauma.

[6]  W. Carson,et al.  Curvature of the Femur and the Proximal Entry Point for an Intramedullary Rod , 1987, Clinical orthopaedics and related research.

[7]  P. Marie,et al.  S12911-2 reduces bone loss induced by short-term immobilization in rats. , 2003, Bone.

[8]  H. Tullos,et al.  The anatomic basis of femoral component design. , 1988, Clinical orthopaedics and related research.

[9]  S. Roach,et al.  Long Gamma Nail Stabilization of Pathologic and Impending Pathologic Femur Fractures , 1999 .

[10]  N. A. Walensky.  A study of anterior femoral curvature in man , 1965, The Anatomical record.

[11]  M. Ballard.  Anterior femoral curvature revisited: race assessment from the femur. , 1999, Journal of Forensic Sciences.

[12]  B M Gilbert,et al.  Anterior femoral curvature: its progably basis and utility as a criterion of racial assessment. , 1976, American journal of physical anthropology.

[13]  D. Christakis,et al.  Architecture of the femoral medullary canal and working length for intramedullary nailing. Biomechanic indications for dynamic nailing. , 1997, Acta orthopaedica Scandinavica. Supplementum.

[14]  E. Schneider,et al.  [Form and dimension of the bone marrow cavity of the human femur with reference to the fit of intramedullary implants]. , 1988, Der Unfallchirurg.

[15]  Eric Y Chang,et al.  Mismatch of Current Intramedullary Nails With the Anterior Bow of the Femur , 2004, Journal of orthopaedic trauma.

[16]  M. Dittmar.  Functional and Postural Lateral Preferences in Humans: Interrelations and Life-Span Age Differences , 2002, Human biology.

[17]  J. Koebke,et al.  Antegrade femoral nailing: an anatomical determination of the correct entry point. , 2002, Injury.

[18]  T. D. Stewart.  Anterior femoral curvature: its utility for race identification. , 1962, Human biology.

[19]  W. Yau,et al.  Sagittal bowing of the distal femur in Chinese patients who require total knee arthroplasty , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  A. Tencer,et al.  Mechanics of intramedullary nails for femoral fractures. , 1990, Der Unfallchirurg.