Relationship Between Prepatellar Fat Thickness and Bone Mineral Density.

OBJECTIVE: To evaluate the relationship between bone mineral density (BMD) by measuring the prepatellar fat thickness with knee radiography and to gain a measurement method that has not been done before in the literature. STUDY DESIGN: Cross-sectional descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation, Training and Research Hospital, Sanliurfa, Turkiye, between January and June 2020. METHODOLOGY: Patients' age, body mass index (BMI) data, prepatellar fat thickness (mm), L1-L4 total, bone mineral density femoral neck, femur trochanter major, and femur total T scores were recorded. The relationships between these three groups (normal, osteopenia, osteoporosis) and between prepatellar fat tissue measurement were evaluated. One-way analysis of variance (ANOVA) and Post Hoc Tukey tests were used in the analysis. RESULTS:  A statistically significant difference was found in terms of trochanter major T score measurements (X2 = 20.435; p <0.001) and BMI (X2 = 66.535; p <0.001) measurements of prepatellar fat thickness measurement. A statistically significant difference was found between the three groups in terms of prepatellar fat thickness measurement, L1-4 T-score, femoral neck, and femur total values (p <0.001). CONCLUSION:  Prepatellar fat thickness in postmenopausal Turkish women was positively correlated with BMD; BMD increases as the prepatellar fat thickness increases. This explains that perapatellar fat thickness creates a mechanical load on the bones and causes an increase in BMD. KEY WORDS: Osteoporosis, Fat thickness, Bone mineral density.

Osteological profiling of femoral diaphysis and neck in aquatic, semiaquatic, and terrestrial carnivores and rodents: effects of body size and locomotor habits.

The increased limb bone density documented previously for aquatic tetrapods has been proposed to be an adaptation to overcome buoyancy during swimming and diving. It can be achieved by increasing the amount of bone deposition or by reducing the amount of bone resorption, leading to cortical thickening, loss of medullary cavity, and compaction of trabecular bone. The present study examined the effects of locomotor habit, body size, and phylogeny on the densitometric, cross-sectional, and biomechanical traits of femoral diaphysis and neck in terrestrial, semiaquatic, and aquatic carnivores, and in terrestrial and semiaquatic rodents (12 species) by using peripheral quantitative computed tomography, three-point bending, and femoral neck loading tests. Groupwise differences were analyzed with the univariate generalized linear model and the multivariate linear discriminant analysis supplemented with hierarchical clustering. While none of the individual features could separate the lifestyles or species adequately, the combinations of multiple features produced very good or excellent classifications and clusterings. In the phocid seals, the aquatic niche allowed for lower femoral bone mineral densities than expected based on the body mass alone. The semiaquatic mammals mostly had high bone mineral densities compared to the terrestrial species, which could be considered an adaptation to overcome buoyancy during swimming and shallow diving. Generally, it seems that different osteological properties at the levels of mineral density and biomechanics could be compatible with the adaptation to aquatic, semiaquatic, or terrestrial niches.

Fully automated measurement of femoral neck axis line in anatomical coordinate system using CT images.

The femoral neck is the most vulnerable site for fractures within the hip joint. Due to its complex three-dimensional structure and special blood supply mechanism, the treatment of femoral neck fractures is difficult and the healing probability is low. Using computers to accurately and automatically locate the femoral neck axis can detect the density of femoral neck, the neck-shaft angle and the anteversion angle, which effectively assists in the prevention and treatment of femoral neck fractures. Additionally, the traditional femoral neck axis positioning schemes have limitations in accuracy, automation and assistance to bone density measurement. Therefore, this paper proposes a new fully automatic femoral neck axis positioning method. First, the coronal plane's three-dimensional reconstruction highlights the details of the target bone, and then designs a coarse localization module based on multi-scale template matching to obtain the rough range of the femoral neck axis. Then, a detailed localization module based on the femoral neck virtual slices is used to obtain the contour centers and accurately locates the three-dimensional femoral neck axis. This method has been validated in comparison with the manual measurement method. Experimental results revealed that the extracted femoral neck axis in this study can achieve automation, ensure accuracy, and avoid subjective effects effectively and has the potential value to be applied in the prevention and treatment of femoral neck fractures.

Anatomical Diversity in Femur bones: Understanding the Morphological Variability for Surgical and Prosthetic Applications / Diversidad Anatómica en Huesos Fémur: Comprensión de la Variabilidad Morfológica para Aplicaciones Quirúrgicas y Protésicas

SUMMARY: The femur, the body's longest bone, plays a critical role in orthopaedics and radiology. Understanding its anatomy, particularly the neck-shaft angle (NSA), is vital for diagnosing bone issues and designing hip implants. While some Asian populations' femur measurements have been studied, there is a research gap concerning Sri Lankans. This study aimed to fill this gap by examining the proximal femur's anatomy in the Sri Lankan population. We analysed 45 adult human femurs (26 right, 19 left) of unknown sex, ethically sourced from the University of Sri Jayewardenepura. Femurs with fractures or pathologies were excluded. Precise measurements were recorded using digital vernier callipers, with millimetre accuracy. Parameters included mean femoral length, vertical and transverse femoral head diameters, neck axis and neck length. Each measurement was taken three times to minimize subjectivity. Right femurs had a mean length of 42.8 mm (SD±2.64), while left femurs measured 43.53 mm (SD±3.27). Mean NSA was 125.78º (SD±4.45) for left femurs and 127.59º (SD±2.06) for right. Mean femoral head diameters were 4.09mm (SD±0.30) (right) and 4.12mm (SD±0.31) (left). Mean anterior neck lengths of the right and left were 2.61 (SD±0.54) and 2.71(SD±0.50) respectively. Comparing our findings with other Asian populations highlighted significant variations in femur measurements. These discrepancies emphasize the need for population-specific data for orthopaedic interventions and raise questions about the suitability of imported prosthetics. Differences in femur length, neck length, and NSA between sides suggest potential challenges in using implants designed for one side on the other. This study underscores the necessity of population-specific data in orthopaedics, as femur measurements differ even among Asian populations. Further research and statistical analysis are essential for tailoring orthopaedic solutions to individual populations. The findings also suggest a potential need for locally manufactured prosthetics to better suit the Sri Lankan population.

El fémur, el hueso más largo del cuerpo, desempeña un papel fundamental en ortopedia y radiología. Comprender su anatomía, en particular el ángulo cuello-diáfisis (NSA), es vital para diagnosticar problemas óseos y diseñar implantes de cadera. Si bien se han estudiado las medidas del fémur de algunas poblaciones asiáticas, existe un vacío en la investigación sobre los habitantes de Sri Lanka. Este estudio tuvo como objetivo examinar la anatomía del fémur proximal en la población de Sri Lanka. Analizamos 45 fémures humanos adultos (26 derechos, 19 izquierdos) de sexo desconocido, obtenidos éticamente de la Universidad de Sri Jayewardenepura. Se excluyeron fémures con fracturas o patologías. Se registraron mediciones precisas utilizando calibradores vernier digitales, con precisión milimétrica. Los parámetros incluyeron la longitud femoral media, los diámetros vertical y transversal de la cabeza femoral, el eje del cuello y la longitud del cuello. Cada medición se tomó tres veces para minimizar la subjetividad. Los fémures derechos tuvieron una longitud media de 42,8 mm (DE ± 2,64), mientras que los fémures izquierdos midieron 43,53 mm (DE ± 3,27). La NSA media fue de 125,78º (DE±4,45) para el fémur izquierdo y de 127,59º (DE±2,06) para el derecho. Los diámetros medios de la cabeza femoral fueron 4,09 mm (DE ± 0,30) (derecha) y 4,12 mm (DE ± 0,31) (izquierda). Las longitudes medias del cuello anterior de la derecha y la izquierda fueron 2,61 (DE ± 0,54) y 2,71 (DE ± 0,50) respectivamente. La comparación de nuestros hallazgos con otras poblaciones asiáticas destacó variaciones significativas en las medidas del fémur. Estas discrepancias enfatizan la necesidad de datos específicos de la población para las intervenciones ortopédicas y plantean dudas sobre la idoneidad de las prótesis importadas. Las diferencias en la longitud del fémur, la longitud del cuello y la NSA entre lados sugieren posibles desafíos al utilizar implantes diseñados para un lado en el otro. Este estudio subraya la necesidad de datos específicos de la población en ortopedia, ya que las mediciones del fémur difieren incluso entre las poblaciones asiáticas. Es esencial realizar más investigaciones y análisis estadísticos para adaptar las soluciones ortopédicas a poblaciones individuales. Los hallazgos también sugieren una posible necesidad de prótesis fabricadas localmente para adaptarse mejor a la población de Sri Lanka.

An Imaging Assessment of the Femoral Neck-shaft Angle in Adult Bengali Bangladeshi Population.

Most orthopaedics implants were designed and manufactured based on data from the Western population whose skeletal dimensions are different from the Bengali Bangladeshi population. This study aims to determine the value of the femoral neck-shaft angle of the adult Bengali Bangladeshi population for adequate planning, preparation and pre-operative selection of orthopaedic implants for surgeries involving the femoral neck and stocking of orthopaedic implants. This was a cross-sectional analytical study which involved measuring the femoral neck-shaft angle (NSA) from the pelvic radiographs anterior-posterior view of adult patients reported "normal study" by the registered radiologist. This study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from March 2019 to February 2020. A total of 200 femoral neck-shaft angles were analyzed from 100 patients' radiographs comprising 50 males and 50 females. The average NSA of adult Bengali Bangladeshi is 128.74°±5.83° with a mean value of 128.68°±6.20° for the right and 128.81°±5.66° for the left. The mean value of NSA is 129.64°±5.90° and 127.85°±5.64° in adult males and females respectively. The femoral neck-shaft angle in adult Bengali Bangladeshi males was significantly higher than the females.

Anatomical features of the proximal femur in the Turkish population / Características anatómicas del fémur proximal en la población turca

SUMMARY: Different populations have different genetic traits, and this causes various anatomical features to emerge. Orthopedic implants used in Turkey are generally of Western origin, and these implants are designed based on the anatomical features of Western populations. This study aimed to evaluate the compatibility of existing implants for the Turkish population by revealing the anatomical features of the proximal femurs of individuals from the Turkish population while also constituting a helpful source of data on newly developed implants. A total of 1920 proximal femurs of 960 patients were evaluated via images obtained by Computer Tomography. Twenty patients (10 females and 10 males) for each age within the age range of 18-65 years were included. Femoral head diameter, femoral neck width, femoral neck length, medullary canal width, and collodiaphyseal angle were measured. The right and left femoral head diameter was 46.46±3.84 mm, 46.50 ±3.85 mm respectively. The right and left femoral neck width was 30.63±3.4 mm, 30.85±3.29 mm respectively. The neck length was 94.62±8.33 mm for the right proximal femur, it was 94.75±8.19 mm for the left. The width of the medullary canal was 15.46±2.25 mm for the right proximal femur and 15.53±2.20 mm for the left. The right and left hips, the collodiaphyseal angles were 133.06±2.39° and 133.13±2.36°. Anatomical features of the proximal femur vary according to age, sex, and race. This study may be used as an important resource for the evaluation of patients' compatibility with existing implants and for the design of new implants.

Diferentes poblaciones tienen diferentes rasgos genéticos, y esto hace que surjan varias características anatómicas. Los implantes ortopédicos utilizados en Turquía son generalmente de origen occidental y estos implantes están diseñados en función de las características anatómicas de estas poblaciones. Este estudio tuvo como objetivo evaluar la compatibilidad de los implantes existentes para la población turca al revelar las características anatómicas de las epífisis proximales de fémures de individuos de la población turca y, al mismo tiempo, constituir una fuente útil de datos sobre implantes recientemente desarrollados. Se evaluaron un total de 1920 fémures proximales de 960 pacientes mediante imágenes obtenidas por tomografía computarizada. Se incluyeron veinte pacientes (10 mujeres y 10 hombres) para cada edad dentro del rango de edad de 18 a 65 años. Se midió el diámetro de la cabeza femoral, el ancho del cuello femoral, la longitud del cuello femoral, el ancho del canal medular y el ángulo colodiafisario. El diámetro de la cabeza femoral derecha e izquierda fue de 46,46 ± 3,84 mm, 46,50 ± 3,85 mm, respectivamente. La anchura del cuello femoral derecho e izquierdo fue de 30,63±3,4 mm, 30,85±3,29 mm, respectivamente. La longitud del cuello fue de 94,62±8,33 mm para el fémur derecho, fue de 94,75±8,19 mm, para el izquierdo. El ancho del canal medular fue de 15,46±2,25 mm para el fémur derecho y de 15,53±2,20 mm para el izquierdo. Las caderas derecha e izquierda, los ángulos colodiafisarios fueron 133,06±2,39° y 133,13±2,36°. Las características anatómicas de la epífisis proximal del fémur varían según la edad, el sexo y la raza. Este estudio puede utilizarse como un recurso importante para la evaluación de la compatibilidad de los pacientes con los implantes existentes y para el diseño de nuevos implantes.

Ghrelin plasma levels, gastric ghrelin cell density and bone mineral density in women with rheumatoid arthritis

Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA) that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD) in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52.70±11.40 years). Patients with RA presented higher ghrelin-immunoreactive cells density in gastric mucosa (P=0.008) compared with healthy females. There was a positive relationship between femoral neck BMD and gastric ghrelin cell density (P=0.007). However, these same patients presented a negative correlation between plasma ghrelin levels and total femoral BMD (P=0.03). The present results indicate that ghrelin may be involved in bone metabolism of patients with RA. However, the higher density of ghrelin-producing cells in the gastric mucosa of these patients does not seem to induce a corresponding elevation in the plasma levels of this peptide.

Evaluation of morphological changes in pharynx with dynamic CT and MRI in snoring patients / Anomalías morfológicas de la faringe en roncadores

Background: Identifying the craniofacial abnormalities that cause snoring and the narrowest area of the upper airway creating obstructions can help to determine the proper method of treatment. Aim: To identify the factors that can cause snoring and the areas of the airway that are the most likely to collapse with upper airway imaging. Material and Methods: Axial pharynx examinations with CT (computerized tomography) and magnetic resonance imaging (MRI) were performed to 38 patients complaining of snoring and 12 patients who did not complain of snoring. The narrowest areas of nasopharynx, hypophraynx, oropharynx, bilateral para-pharyngeal fat pad and para-pharyngeal muscle thickness were measured. Results: In snoring patients, the narrowest part of the upper airway was the retro-palatal region in the oropharynx, as measured with both imaging methods. When patients with and without snoring were compared, the former that a higher body mass index and neck diameter and a narrower oropharynx area. In dynamic examinations, we determined that as para-pharyngeal muscle thickness increased, medial-lateral airway diameter and the oropharynx area decreased. Conclusions: The narrowest section of the airway is the retro-palatal region of the oropharynx, measured both with CT and MRI.

Antecedentes: La identificación de las anomalías craneofaciales que causan el ronquido es importante para decidir la terapia adecuada. Objetivo: Identificar los factores que causan el ronquido y las zonas de la vía aérea superior que son más susceptibles de colapsar, usando imágenes. Material y Métodos: Se efectuaron exámenes axiales de la faringe con tomografía computada (TC) y resonancia magnética (RM) en 38 pacientes que roncaban y 12 que no lo hacían. Se determinaron las zonas más estrechas de la nasofaringe, hipofaringe, orofaringe y el grosor del tejido adiposo y musculatura parafaríngeos. Resultados: En los pacientes que roncaban la zona más estrecha de la vía aérea superior fue la zona retro-palatal en la orofaringe. Los pacientes roncadores tenían un índice de masa corporal y diámetro cuello mayores y un área orofaríngea menor. En los exámenes dinámicos observamos que a medida que el grosor de los músculos parafaríngeos aumentó, disminuyó el área medial y lateral de la vía aérea y el área de la orofaringe. Conclusiones: La zona más estrecha de la vía aérea superior es la región retropalatal de la orofaringe, medida tanto con TC como con RM.

Version of femoral neck: a cadaveric dried bone study / Versión del cuello femoral: estudio cadavérico sobre huesos secos

The aim of this study was to measure the version of femoral neck on dried Thai human femora. The version of femoral neck varies widely. It is important to know the version of femoral neck in a particular population to undertake successful femoral neck reconstructive surgery. Paired 216 dried femora of adult Thais from the bone collection maintained in the Department of Anatomy at the Faculty of Medicine, Khon Kaen University, Thailand, were used to measure the version of femoral neck. The mean+SD femoral anteversion (FNA) was 16.21+5.24 degrees. The 95% confidence interval of FNA was from 15.48 to 16.94 degrees. The 95% confidence intervals of male and female average FNA were 14.75 to 16.90 and 15.59 to 17.59 degrees respectively. There was no significance difference of the FNA between males and females in both anteversion and retroversion groups. The average male FNA showed no statistical difference to average female anteversion. The 95% confidence intervals of males and females average retroversion were -8.22 to -4.80 and -7.71 to -4.47 degrees respectively. The average male retroversion showed no statistical difference to average female retroversion. The overall 95% confidence interval of femoral neck anteversion and retroversion were 15.48 to 16.94 degrees and -7.33 to -5.27 with no significant difference between males and females. These degrees of FNA must be considered when the femoral neck reconstructive surgery is planned.

El objetivo fue medir el cuello femoral en fémures humanos de tailandeses adultos. La versión del cuello femoral es muy variable. Es importante conocer la versión de cuello femoral en una población en particular para llevar a cabo con éxito una cirugía reconstructiva. Se utilizaron 216 fémures secos de adultos tailandeses obtenidos de la colección del Departamento de Anatomía de la Facultad de Medicina de la Universidad de Khon Kaen, Tailandia. La anteversión femoral (AFM) media+DE fue de 16,21±5,24. El intervalo de confianza del 95% de la AFM fue entre 15,48 a 16,94. El promedio de intervalos de confianza del 95% en hombres y mujeres fue desde 14,75 a 16,90 y 15,59 a 17,59, respectivamente. No hubo diferencia significativa entre hombres y mujeres en ambos grupos de anteversión y retroversión. La AFM promedio en hombres no mostró diferencia significativa con la anteversión media de las mujeres. Se observó un promedio de -8,22 a -4,80 y -7,71 a -4,47 en el 95% de los intervalos de confianza entre hombres y mujeres, respectivamente. La retroversión promedio en hombres no mostró ninguna diferencia significativa con la retroversión media en las mujeres. Estos grados de AFM deben ser considerados en la planificación de una cirugía reconstructiva del cuello femoral.

Proximal femoral epiphysis anatomy in chilean population: orthopedic and forensic aspects / Anatomía del epífisis proximal del fémur en la población chilena. Aspectos traumatológicos y forenses

From a biomechanical standpoint, bone geometry and density are factors correlated to the bone resistance of the femur when supporting body weight, with geometric parameters like the diameter of the femoral head and neck, the length of the femoral neck, and the femoral neck angle as determinant factors in the incidence of hip fractures, which increase in frequency and seriousness in osteoporotic patients. In Chile, morphometric data that contributes to relating the anatomy of the proximal epiphysis of the femur as an associated factor in hip fractures does not exist; likewise, there are no anthropometric indexes that may contribute to the forensic sciences. The purpose of this study is to establish average measurements of the proximal epiphysis of the femur in the adult Chilean population. Descriptive Study. The proximal epiphyses of 81 dry adult femurs were analyzed (44 right and 37 left bones), measuring the following parameters: length of the femoral neck (LN), femoral neck angle (FNA), circumference of the femoral head (CH) and circumference of the femoral neck (CN). The statistical relationship between the measurements and the side of each sample was analyzed (t-test p=0.05). The average lengths were LN= 3.59cm (+/- 0.43 cm); FNA= 124.17 (+/- 6.37), CH= 14.34 cm (+/- 1.27 cm) and CN= 9.7 cm (+/- 0.87 cm). No significant differences between the left and right sides were found. Average numbers were obtained for the anatomy of the proximal femoral epiphysis from a sample in the Chilean population. With the data obtained, we propose to carry out anatomo-clinical, epidemiologic and forensic studies in this population.

Desde un punto de vista biomecánico, la geometría y la densidad ósea son factores correlacionados con la resistencia del hueso del fémur al apoyar el peso corporal, con los parámetros geométricos, como el diámetro de la cabeza femoral y el cuello, la longitud del cuello del fémur, y el ángulo del cuello femoral factores determinantes en la incidencia de fracturas de cadera, que aumentan en frecuencia y gravedad en los pacientes con osteoporosis. En Chile, no existen datos morfométricos que relacionen la anatomía de la epífisis proximal del fémur como un factor asociado a las fracturas de cadera ni índices antropométricos que pueden contribuir a las ciencias forenses. El propósito de este estudio es establecer las medidas promedio de la epífisis proximal de fémur en población adulta chilena. Estudio Descriptivo. Se analizaron la epífisis proximal de 81 fémures adultos secos (44 derechos y 37 izquierdos), midiendo los siguientes parámetros: longitud del cuello femoral (LC) , ángulo cérvico-diafisiario femoral (ACD), circunferencia de la cabeza femoral (CCa) y circunferencia del cuello femoral (CCu). Se analizó la relación estadística de las medidas con el lado de cada muestra (test Chi cuadrado p:0,05) Las longitudes promedios fueron LC: 3,59 cm (+/- 0,43 cm); ACD: 124,17 (+/- 6,37 cm); CCa: 14,34 cm (+/- 1,27 cm) y CCu: 9,7 cm (+/- 0,87 cm). No se encontraron diferencias significativas entre el lado derecho e izquierdo. Los resultados proponen la necesidad de realizar estudios anatomo-clínicos y epidemiológicos actualizados en población chilena donde la geometría de la epífisis proximal del fémur se incluya dentro del análisis.

Morphometric study of the proximal femur extremity in Brazilians / Estudio morfométrico del extremo proximal del fémur en brasileños

Brazilian populational aging besides higher life expectancy has increased the incidence of proximal femoral fractures. Treatment of those fractures uses implants which are based in measurements performed in caucasians, including the 135 degrees cervical-diaphyseal angle. Knowing femoral morphometry allows evaluating implants adequability. We performed our study using 110 Brazilian human femurs (49 right and 61 left). We excluded from the study: bones submitted to osteosyntesis, to prosthetization or those showing abnormalities or malformations which could affect its structure and shape. Bones were submitted to roetgenographic analysis and the images were scanned and transferred to personal computer. Measurements were obtained by AutoCad software and statistics by Graph Pad Instat software. Our data were compared using Kolmogorov-Smirnov and "t-test". The following parameters were evaluated: femoral head diameter (FHD), femoral neck length (FNL), femoral neck width (FNW), femoral axis length (FAL), off-set (OS) and cervical-diaphyseal angle (CDA). The findings were as follows (mean +/- SD), right and left sides respectively: FHD, 31.1 +/- 2.7 mm and 30.8 +/- 3.0 mm; FNL, 30.1 +/- 4.3 mm and 30.5 +/- 4.1mm; FNW, 30.96 +/- 2.94 mm; FAL, 98.2 +/- 5.9 mm and 97.4 +/- 7.13 mm; OS, 42.6 +/- 6.1 mm and 42.0 +/- 5.6 mm; CDA, 132.0 +/- 7.2 e 131.8 +/- 5.2. Median cervical-diaphyseal angle, obtained in this study presented some variation, which was not statistically significant. Linear data are constant, according to other studies, except the off-set, which has varied.

Junto al envejecimiento de la población de Brasil, producto de la mayor expectativa de vida, ha aumentado la incidencia en las fractura de la parte proximal del fémur. Para el tratamiento de estas fracturas se utilizan implantes, los que están basados en mediciones realizadas en caucásicos, incluido los 135 grados del ángulo cervico-diafisario. Conocer la morfometría femoral permite evaluar adecuabilidad de los implantes. Se realizó este estudio con 110 fémures humanos (49 derechos y 61 izquierdos) de individuos brasileños. Se excluyeron del estudio: los huesos sometidos a osteosíntesis, a prótesis o en los que se detectaron anormalidades o malformaciones que pudieran afectar su estructura y forma. Los huesos fueron sometidos a análisis radiográfico y las imágenes digitalizadas y transferidas a un computador personal. Las mediciones se obtuvieron mediante el software AutoCAD y las estadísticas con el software Instat. Nuestros datos se compararon con la prueba de Kolmogorov-Smirnov y "t-test". Los siguientes parámetros fueron evaluados: diámetro de la cabeza del fémur (FHD), longitud del cuello femoral (FNL), ancho del cuello femoral (FNW), longitud del eje del fémur (FAL), off-set (OS) y el ángulo cérvico-diafisario (CDA). Los resultados fueron los siguientes (media +/- SD), a la derecha e izquierda respectivamente: FHD, 31,1 +/- 2,7mm y 30,8 +/- 3,0 mm; FNL 30,1 +/- 4,3 mm y 30,5 +/- 4,1mm; FNW 30,96 +/- 2,94mm; FAL 98,2 +/- 5,9mm y 97,4 +/- 7,13mm; OS 42,6 +/- 6,1mm y 42,0 +/- 5,6mm; CDA 132,0 +/- 7,2 y 131,8 +/- 5,2. Los ángulos cérvico-diafisarios medianos obtenidos en este estudio presentaron alguna variación, que no fue estadísticamente significativa. Los datos lineales fueron constantes en acuerdo con otros estudios, excepto el off-set, que ha variado.

Estudio del ángulo del cuello del fémur en cadáveres del departamento de anatomía de la Facultad de Medicina - PUC-SP / Study of the collo-diaphyseal angle of the femur of corpses in the Anatomy Department of the PUC-SP Medical School

In Brazilian literature the works are scarce on the collo-diaphyseal angle (CDA) in Brazilians, as well as, in relation to the other measures that can be acquired in the proximal portion of the femur, as the femur axle length (FAL), femur neck width (FNW), and the femur head diameter (FHD).This study had the purpose of enlarging the data on the Brazilian people, providing anatomic fundamentals that allow a better comprehension of clinical and pathological states involving the hip joint. All these measures were gotten in millimeters (mm) through a paquimeter and a goniometer for the same researcher. Eighty-seven bones were analyzed, being 40 (46 percent) right femurs and 47 (56 percent) left femurs. The bones were in their complete form and they were from adult corpse. For the analysis of measures were used Friedman's analysis of variance to compare, separately, for the sides right and left, the values of the five measures effected by the researchers; the test of Student for two not independent samples, with the objective to compare, for each corpse, the values of the observed angle in the right and left side. The results were: right-CDA 128.23° +/- 4.43 and left-CDA 128.04° +/- 4.36, right-FAL 90.14mm +/- 5.53 and left-FAL 91.08mm +/- 5.48, right-FNW 28.69mm +/- 2.58 and left-FNW 28.81mm +/- 3.28, andright-FHD 41.80mm +/- 3.10 andleft-FHD 42.11 +/- 3.42. In conclusion, it is necessary to emphasize the importance of femoral geometry data of Brazilian bones in this study which could be compared to values carried out in other Brazilian states since the Brazil continental size causes variations in the population. Also it is imperative to emphasize the future possibility of applying this knowledge in clinical practice, especially in relation to the risk of bone fracture.

En la literatura brasileña los trabajos sobre el ángulo del cuello del fémur (CDA) son escasos, así como de las otras medidas que pueden adquirirse en la porción proximal del hueso, como la longitud del cuello del fémur (FAL), anchura de cuello del fémur (FNW), y el diámetro de la cabeza del fémur (FHD). Este estudio tiene el propósito de aumentar los datos de individuos brasileños, proporcionando principios anatómicos que permitan una mejor comprensión de estados clínicos y patológicos que involucran la articulación de la cadera. Todas estas medidas se consiguieron en milímetros (mm) a través de un paquímetro y un goniómetro, por un mismo investigador. Se analizaron 87 huesos, siendo 40 (46 por ciento) fémures derechos y 47 (56 por ciento) fémures. Los huesos estaban enteros y eran de individuos adultos. Para analizar las medidas se usó Análisis de Varianza de Friedman para comparar, separadamente, los lados derecho y izquierdo, los valores de las cinco medidas efectuados por los mismos investigadores; la prueba t-Student para las muestras independientes, con el objetivo de comparar, para cada cadáver, los valores del ángulo observado en los lados derecho e izquierdo. Los resultados fueram: derecho-CDA 128.23° +/- 4.43 e izquierdo-CDA 128.04° +/- 4.36, derecho-FAL 90.14mm +/- 5.53 e izquierdo-FAL 91.08mm +/- 5.48, derecho-FNW 28.69mm +/- 2.58 e izquierdo-FNW 28.81mm +/- 3.28, y derecho-FHD 41.80mm +/- 3.10 e izquierdo-FHD 42.11 +/- 3.42. En conclusión, son importantes los datos de geometría femoral de huesos brasileños obtenidos en este estudio, para poder compararlos con valores obtenidos en individuos de otros estados brasileños, debido el tamaño continental de Brasil, que causa variaciones en su población. También es importante la posibilidad de aplicar en el futuro geometría de la porción proximal del fémur en la práctica médica, sobre todo cuando existe riesgo de fractura del hueso.

A verdadeira fratura do colo do fêmur / The real fracture of temoral neck

Cento e vinte e seis cabeças femorais retiradas durante artroplasias de quadril para tratamento de fraturas do colo do fêmur foram estudadas macroscopicamente e radiograficamente quanto ao traço de fratura e a existência de colo inferior que pode permanecer junto com a cabeça femoral. Chegou-se a conclusão que as fraturas do colo do fêmur obedecem a uma constância quanto ao traço de fratura, e que não existe a fratura subcapital, pois em todos os casos analisados havia um fragmento de colo junto com a cabeça (esporão).