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Proximal Femoral Anatomy in the Normal Human Population
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Original Article
Proximal Femoral Anatomy in the Normal Human Population
Paul A. Toogood1  , Anthony Skalak2 and Daniel R. Cooperman2
| (1) |
Department of Orthopaedics, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, 2423 Overlook Road, Apartment 7, Cleveland Heights, OH 44106, USA |
| (2) |
Department of Orthopaedics, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106, USA |
Received: 30 March 2008 Accepted: 8 August 2008 Published online: 29 August 2008
Abstract In this study, we developed a complete description of the morphology of the proximal femur. Then, using this framework, we
(1) determined normal population means, standard deviations, and ranges; (2) established differences among subpopulations;
and (3) showed correlations among the various measurements. To accomplish these objectives, we analyzed 375 adult femurs.
Specimens were digitally photographed in standardized positions, measurements being obtained using ImageJ software. Three
parameters of the head-neck relationship were assessed. Translation was examined through four raw offset measurements (anterior,
posterior, superior, inferior) used to calculate anterior-posterior and superior-inferior ratios. Rotation was investigated
through anteroposterior (AP) and lateral physeal angles. Concavity was examined using alpha, beta, gamma, and delta angles.
Two parameters of the neck-shaft relationship were assessed, neck version and angle of inclination. Average anterior-posterior
and superior-inferior ratios were 1.14 and 0.90. Average AP and lateral physeal angles were 74.33° and 81.83°, respectively.
Averages for alpha, beta, gamma, and delta angles were 45.61°, 41.85°, 53.46°, and 42.95°, respectively. Average neck version
and angle of inclination were 9.73° and 129.23°, respectively. Differences existed between males and females and between those
younger and older than 50 years. Correlations were observed between translation and concavity, and translation and the neck-shaft
relationships.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.
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