Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D) space. Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium). The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly. Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r = 0.24, p < 0.01) and between the femoral length and the isthmus height (r = 0.6, p < 0.01). Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus. Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants.

[1]  W. Marsden.  I and J , 2012 .

[2]  Georges-Yves Laflamme,et al.  Comparative study of femoral diaphyseal morphometry in two male populations, in France and a French West Indies island: an example of clinical relevance of comparative anatomy for orthopedic practice , 2010, Surgical and Radiologic Anatomy.

[3]  R. Malhotra,et al.  Anthropometric measurements to design best-fit femoral stem for the Indian population , 2012, Indian journal of orthopaedics.

[4]  P. Leyvraz,et al.  Three-dimensional morphology of the proximal femur. , 1997, The Journal of arthroplasty.

[5]  김범수.  Residual pain due to soft-tissue impingement after uncomplicated total ankle replacement , 2013 .

[6]  Kevin Barraclough,et al.  I and i , 2001, BMJ : British Medical Journal.

[7]  Aaas News,et al.  Book Reviews , 1893, Buffalo Medical and Surgical Journal.

[8]  Hao Zhang,et al.  Predicting the optimal entry point for femoral antegrade nailing using a new measurement approach , 2015, International Journal of Computer Assisted Radiology and Surgery.

[9]  M. Alpaslan,et al.  [Osteometry of the femora in Turkish individuals: a morphometric study in 114 cadaveric femora as an anatomic basis of femoral component design]. , 2007, Acta orthopaedica et traumatologica turcica.

[10]  G. G. Stokes.  "J." , 1890, The New Yale Book of Quotations.

[11]  Vivek Trikha,et al.  Uncoiling of reamer during intramedullary nailing for fracture shaft of femur , 2013, Journal of natural science, biology, and medicine.

[12]  H. Tullos,et al.  The effect of aging on the shape of the proximal femur. , 1995, Clinical orthopaedics and related research.

[13]  M. Lehto,et al.  Image processing for femoral endosteal anatomy detection: description and testing of a computed tomography based program. , 1997, Physics in medicine and biology.

[14]  Banchong Mahaisavariya,et al.  Morphological study of the proximal femur: a new method of geometrical assessment using 3-dimensional reverse engineering. , 2002, Medical engineering & physics.

[15]  W. Buford,et al.  Three-Dimensional Computed Tomography–Based Modeling of Sagittal Cadaveric Femoral Bowing and Implications for Intramedullary Nailing , 2014, Journal of orthopaedic trauma.

[16]  H J Mankin,et al.  Epithelioid sarcoma in the upper extremity. , 1992, The Journal of bone and joint surgery. American volume.

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

[18]  T. Moilanen,et al.  Diversity of proximal femoral medullary canal. , 2000, The Journal of arthroplasty.

[19]  F. Lavaste,et al.  The anatomic basis for the concept of lateralized femoral stems: a frontal plane radiographic study of the proximal femur. , 2000, The Journal of arthroplasty.

[20]  K. Mak,et al.  Breakage of Intramedullary Femoral Guide Rod during Total Knee Arthroplasty: A Case Report , 2006, Journal of orthopaedic surgery.

[21]  Yong-Qing Wang,et al.  An intramedullary nail with multifunctional interlocking for all types of fracture in both femurs , 2009, Orthopaedic surgery.

[22]  W K Kim,et al.  Cementless press-fit and fibrous or bony ingrowth "Asian total hip prosthesis" design using computed axial tomography and computer aided design and computer aided manufacturing (Part 1: Computer graphics of femoral canal for intramedullary stem prosthesis). , 1987, Yonsei medical journal.

[23]  Alias Mohd Noor,et al.  Morphological Study of the Newly Designed Cementless Femoral Stem , 2014, BioMed research international.

[24]  M. Bartley,et al.  Roentgenographic and direct measurement of femoral cortical involution in a prehistoric Mississippian population. , 1969, American journal of physical anthropology.

[25]  Gon Khang,et al.  A Study of Korean Femoral Geometry , 2003, Clinical orthopaedics and related research.

[26]  P. Leyvraz,et al.  The morphology of the proximal femur. A three-dimensional radiographic analysis. , 1992, The Journal of bone and joint surgery. British volume.

[27]  D. Beverland,et al.  The effects of age and gender on the diameter of the femoral canal in patients who undergo total hip replacement. , 2013, The bone & joint journal.

[28]  F Baruffaldi,et al.  Computerized morphometric analysis of the femoral diaphyseal canal. , 1995, La Chirurgia degli organi di movimento.

[29]  Y H Kim,et al.  Cementless bony ingrowth total hip prosthesis (anatomical contact porous coated total hip prosthesis) design using computed axial tomography and computer aid design. , 1988, Yonsei medical journal.

[30]  Miss A.O. Penney.  (b) , 1974, The New Yale Book of Quotations.

[31]  Sayed Ali,et al.  The Validity and Reliability of Preoperative Radiographic Canal Diameter Measurements of the Femur , 2013, HSS Journal ®.

[32]  Norazman Abdul Majid,et al.  Design process of cementless femoral stem using a nonlinear three dimensional finite element analysis , 2014, BMC Musculoskeletal Disorders.

[33]  Shinichi Imura,et al.  Fit and fill analysis of a newly designed femoral stem in cementless total hip arthroplasty for patients with secondary osteoarthritis , 1997 .

[34]  S. Walter,et al.  Sample size and optimal designs for reliability studies. , 1998, Statistics in medicine.

[35]  S. Harris,et al.  A local reference frame for describing the proximal human femur: application in clinical settings , 2014, Skeletal Radiology.

[36]  Nobuhiko Sugano,et al.  Three-Dimensional Shape of the Dysplastic Femur: Implications for THR , 2003, Clinical orthopaedics and related research.