Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip
Abstract Background When performing femoral reconstruction in patients with Crowe type IV developmental dysplasia of the hip (DDH), anatomical deformity presents many technical challenges to orthopedic surgeons. The false acetabulum is suggested to influence load transmission and femoral development...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-021-02789-5 |
| _version_ | 1818474883707830272 |
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| author | Yuhui Yang Weihong Liao Weiqun Yi Hai Jiang Guangtao Fu Yuanchen Ma Qiujian Zheng |
| author_facet | Yuhui Yang Weihong Liao Weiqun Yi Hai Jiang Guangtao Fu Yuanchen Ma Qiujian Zheng |
| author_sort | Yuhui Yang |
| collection | DOAJ |
| description | Abstract Background When performing femoral reconstruction in patients with Crowe type IV developmental dysplasia of the hip (DDH), anatomical deformity presents many technical challenges to orthopedic surgeons. The false acetabulum is suggested to influence load transmission and femoral development. The aim of this study was to describe the morphological features of dysplastic femurs in Crowe type IV DDH and further evaluate the potential effect of the false acetabulum on morphological features and medullary canal of Crowe type IV femurs. Methods We analyzed preoperative computed tomography scans from 45 patients with 51 hips (25 hips without false acetabulum in the IVa group and 26 hips with false acetabulum in the IVb group) who were diagnosed with Crowe type IV DDH and 30 normal hips in our hospital between January 2009 and January 2019. Three-dimensional reconstruction was performed using Mimics software, and the coronal femoral plane was determined to evaluate the following parameters: dislocation height, dislocation ratio, height of the femoral head (FH), height of the greater trochanter (GT), GT–FH height discrepancy, height of the isthmus, neck-shaft angle, femoral offset and anteversion of the femoral neck. The mediolateral (ML) width, anterolateral (AP) width and diameter of medullary canal of the proximal femur were measured on the axial sections. Further, canal flare index (CFI), metaphyseal-CFI and diaphyseal-CFI were also calculated. Results Compared with the normal femurs, the Crowe type IV DDH femurs had a higher femoral head, larger GT–FH height discrepancy, larger femoral neck anteversion, higher isthmus position and smaller femoral offset. Dislocation height and dislocation rate were significantly larger in the IVa DDH group (65.34 ± 9.83 mm vs. 52.24 ± 11.42 mm). Further, the IVb femurs had a significantly lower isthmus position, larger neck-shaft angle and smaller femoral neck anteversion than IVa femurs. The ML, AP canal widths and the diameter of medullary canal in both DDH groups were significantly smaller than the normal group. Dimensional parameters of IVa femurs were also narrower than IVb femurs in most sections, but with no difference at the level of isthmus. According to the CFIs, the variation of proximal medullary canal in IVb femurs was mainly located in the diaphyseal region, while that in IVa femurs was located in the whole proximal femur. Conclusions High dislocated femurs are associated with more anteverted femoral neck, smaller femoral offset and narrower medullary canal. Without stimulation of the false acetabulum, IVa DDH femurs were associated with higher dislocation and notably narrower medullary canal, whose variation of medullary canal was located in the whole proximal femur. |
| first_indexed | 2024-04-14T04:42:26Z |
| format | Article |
| id | doaj.art-1560f99308cc40ffa4f0165e57be12d6 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T04:42:26Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1560f99308cc40ffa4f0165e57be12d62022-12-22T02:11:36ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-0116111010.1186/s13018-021-02789-5Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hipYuhui Yang0Weihong Liao1Weiqun Yi2Hai Jiang3Guangtao Fu4Yuanchen Ma5Qiujian Zheng6Department of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Operating Room, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Orthopedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesAbstract Background When performing femoral reconstruction in patients with Crowe type IV developmental dysplasia of the hip (DDH), anatomical deformity presents many technical challenges to orthopedic surgeons. The false acetabulum is suggested to influence load transmission and femoral development. The aim of this study was to describe the morphological features of dysplastic femurs in Crowe type IV DDH and further evaluate the potential effect of the false acetabulum on morphological features and medullary canal of Crowe type IV femurs. Methods We analyzed preoperative computed tomography scans from 45 patients with 51 hips (25 hips without false acetabulum in the IVa group and 26 hips with false acetabulum in the IVb group) who were diagnosed with Crowe type IV DDH and 30 normal hips in our hospital between January 2009 and January 2019. Three-dimensional reconstruction was performed using Mimics software, and the coronal femoral plane was determined to evaluate the following parameters: dislocation height, dislocation ratio, height of the femoral head (FH), height of the greater trochanter (GT), GT–FH height discrepancy, height of the isthmus, neck-shaft angle, femoral offset and anteversion of the femoral neck. The mediolateral (ML) width, anterolateral (AP) width and diameter of medullary canal of the proximal femur were measured on the axial sections. Further, canal flare index (CFI), metaphyseal-CFI and diaphyseal-CFI were also calculated. Results Compared with the normal femurs, the Crowe type IV DDH femurs had a higher femoral head, larger GT–FH height discrepancy, larger femoral neck anteversion, higher isthmus position and smaller femoral offset. Dislocation height and dislocation rate were significantly larger in the IVa DDH group (65.34 ± 9.83 mm vs. 52.24 ± 11.42 mm). Further, the IVb femurs had a significantly lower isthmus position, larger neck-shaft angle and smaller femoral neck anteversion than IVa femurs. The ML, AP canal widths and the diameter of medullary canal in both DDH groups were significantly smaller than the normal group. Dimensional parameters of IVa femurs were also narrower than IVb femurs in most sections, but with no difference at the level of isthmus. According to the CFIs, the variation of proximal medullary canal in IVb femurs was mainly located in the diaphyseal region, while that in IVa femurs was located in the whole proximal femur. Conclusions High dislocated femurs are associated with more anteverted femoral neck, smaller femoral offset and narrower medullary canal. Without stimulation of the false acetabulum, IVa DDH femurs were associated with higher dislocation and notably narrower medullary canal, whose variation of medullary canal was located in the whole proximal femur.https://doi.org/10.1186/s13018-021-02789-5Developmental dysplasia of the hipCrowe IVFemoral morphologyThree-dimensional reconstructionTotal hip arthroplasty |
| spellingShingle | Yuhui Yang Weihong Liao Weiqun Yi Hai Jiang Guangtao Fu Yuanchen Ma Qiujian Zheng Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip Journal of Orthopaedic Surgery and Research Developmental dysplasia of the hip Crowe IV Femoral morphology Three-dimensional reconstruction Total hip arthroplasty |
| title | Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip |
| title_full | Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip |
| title_fullStr | Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip |
| title_full_unstemmed | Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip |
| title_short | Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip |
| title_sort | three dimensional morphological study of the proximal femur in crowe type iv developmental dysplasia of the hip |
| topic | Developmental dysplasia of the hip Crowe IV Femoral morphology Three-dimensional reconstruction Total hip arthroplasty |
| url | https://doi.org/10.1186/s13018-021-02789-5 |
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