A novel radiological proximal femoral angles facilitate peritrochanteric surgery

Abstract

Introduction : The geometry of the proximal femur has gained very much attention in the last decade. Many radiological measures have been introduced to help radiologists and orthopaedic surgeons to evaluate surgeries, diagnose diseases and plan for surgical interventions. The main purpose of this study was to assess the validity of a novel radiological land marks and angles to help in Dynamic Hip screw (DHS) application surgery in the proximal femur.

 Patients and methods : 200 true hip anteroposterior radiographs  were obtained for patients between ages 50 to 80 years. We have developed the lesser trochanteric fovea capitis angle (LTFCA) and the lesser trochanteric lateral cortex angle (LTLFCA). Patients were divided into two groups, the male group (n=100) and the female group (n=100). The LTFCA + LTLFCA were assessed in the left and right hips in both genders.

Results : In  male population, the average LTFCA + LTLFCA values for the right and left hip joints were (133.2°±5.27, 134.5°±4.92) respectively. There was no statistical difference between both sides, p= 0.74. Whereas in female population, the average LTFCA + LTLFCA values for the right and left hip joints were (134.8°±6.13, 135.6°±5.45) respectively. No statistical significance was detected between the two sides,  p=0.37.

Conclusion : The LTFCA is an easy method that can facilitate trustable radiological land marks for surgeons for a proper DHS insertion. further studies should be conducted to evaluate the sensitivity and specificity of the lesser trochanteric fovea capitis angle (LTFCA) and its validity in proximal femoral surgery.