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Position of the greater trochanter and functional femoral antetorsion.

Abstract Aims The primary aim of this study was to define and quantify three new measurements to indicate the position of the greater trochanter. Secondary aims were to define 'functional antetorsion' as it relates to abductor function in populations both with and without torsional abnormality. Patients and Methods Three new measurements, functional antetorsion, posterior tilt, and posterior translation of the greater trochanter, were assessed from 61 CT scans of cadaveric femurs, and their reliability determined. These measurements and their relationships were also evaluated in three groups of patients: a control group (n = 22), a 'high-antetorsion' group (n = 22) and a 'low-antetorsion' group (n = 10). Results In the cadaver group, the mean anatomical antetorsion was 14.7° (sd 8.5; 0 to 36.5) and the functional antetorsion 21.5° (sd 8.1; 3.6 to 44.3): the posterior tilt was 73.3° (sd 10.8; 46.9 to 88.7) and the posterior translation 0.59 (sd 0.2; 0.2 to 0.9). These measurements had excellent intra and interobserver agreement with a range from 0.93 to 0.99. When the anatomical antetorsion decreased, the greater trochanter was more tilted and translated posteriorly in relation to the axis of the femoral neck, and the difference between functional and anatomical antetorsion increased. The results the three patient groups were similar to those of the cadaver group. Conclusion The position of the greater trochanter and functional antetorsion varied with anatomical antetorsion. In the surgical management of femoral retrotorsion, subtrochanteric osteotomy can result in an excessively posterior position of the greater trochanter and an increase in functional antetorsion. Cite this article: Bone Joint J 2018;100-B:712-19.
PMID
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Authors

Mayor MeshTerms
Keywords

Femoral antetorsion

Gluteus medius

Greater trochanter

Subtrochanteric osteotomy

Journal Title the bone & joint journal
Publication Year Start




PMID- 29855251
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 6
DP  - 2018 Jun 1
TI  - Position of the greater trochanter and functional femoral antetorsion.
PG  - 712-719
LID - 10.1302/0301-620X.100B6.BJJ-2017-1068.R1 [doi]
AB  - Aims The primary aim of this study was to define and quantify three new
      measurements to indicate the position of the greater trochanter. Secondary aims
      were to define 'functional antetorsion' as it relates to abductor function in
      populations both with and without torsional abnormality. Patients and Methods
      Three new measurements, functional antetorsion, posterior tilt, and posterior
      translation of the greater trochanter, were assessed from 61 CT scans of
      cadaveric femurs, and their reliability determined. These measurements and their 
      relationships were also evaluated in three groups of patients: a control group (n
      = 22), a 'high-antetorsion' group (n = 22) and a 'low-antetorsion' group (n =
      10). Results In the cadaver group, the mean anatomical antetorsion was 14.7
      degrees (sd 8.5; 0 to 36.5) and the functional antetorsion 21.5 degrees (sd 8.1; 
      3.6 to 44.3): the posterior tilt was 73.3 degrees (sd 10.8; 46.9 to 88.7) and the
      posterior translation 0.59 (sd 0.2; 0.2 to 0.9). These measurements had excellent
      intra and interobserver agreement with a range from 0.93 to 0.99. When the
      anatomical antetorsion decreased, the greater trochanter was more tilted and
      translated posteriorly in relation to the axis of the femoral neck, and the
      difference between functional and anatomical antetorsion increased. The results
      the three patient groups were similar to those of the cadaver group. Conclusion
      The position of the greater trochanter and functional antetorsion varied with
      anatomical antetorsion. In the surgical management of femoral retrotorsion,
      subtrochanteric osteotomy can result in an excessively posterior position of the 
      greater trochanter and an increase in functional antetorsion. Cite this article: 
      Bone Joint J 2018;100-B:712-19.
FAU - Batailler, C
AU  - Batailler C
AD  - CHU Lyon Croix-Rousse, Hospices Civils de Lyon, Lyon, France, Clinic for
      Orthopaedic and Trauma Surgery, Lucerne, Switzerland.
FAU - Weidner, J
AU  - Weidner J
AD  - Clinic for Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne,
      Switzerland.
FAU - Wyatt, M
AU  - Wyatt M
AD  - Clinic for Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne,
      Switzerland.
FAU - Dalmay, F
AU  - Dalmay F
AD  - Biostatistics Department, Limoges University, Limoges, France.
FAU - Beck, M
AU  - Beck M
AD  - Clinic for Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne,
      Switzerland.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Biomechanical Phenomena
MH  - Bone Anteversion/*diagnostic imaging/physiopathology
MH  - Cadaver
MH  - Female
MH  - Femur/*diagnostic imaging/pathology
MH  - Hip Joint/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed/methods
MH  - Young Adult
OTO - NOTNLM
OT  - Femoral antetorsion
OT  - Gluteus medius
OT  - Greater trochanter
OT  - Subtrochanteric osteotomy
EDAT- 2018/06/02 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/06/02 06:00
PHST- 2018/06/02 06:00 [entrez]
PHST- 2018/06/02 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1302/0301-620X.100B6.BJJ-2017-1068.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jun 1;100-B(6):712-719. doi:
      10.1302/0301-620X.100B6.BJJ-2017-1068.R1.