Description of Proximal Femoral Growth in Pediatric Patients Without Hip Disorders Using Tomography
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Published:
Aug 20, 2024
Keywords:
Femoral head, femoral neck, human development
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Abstract
Introduction: This study aims to perform a descriptive analysis of proximal femoral growth in a Latin-American population through femoral offset, neck-shaft angle, femoral neck length, and femoral head diameter evaluated through computed tomography in pediatric patients without hip pathology.
Materials and Methods: Retrospective study evaluating CT images of the hips of healthy patients under 18 years. The following measurements were taken by a trained orthopedist: femoral offset, femoral neck length,femoral head diameter, and neck-shaft angle.
Results: Femoral offset increases by 1.96 mm until age 12.5. From 12.5 to 16 years of age, it increases by 1.2 mm. A constant rise in the growth of the femoral neck length was found. The neck-shaft angle presented a progressive decrease until age 12. After that point, the curve flattened. An increase in femoral head diameter of 1.56 mm per year was observed until age 13 and then 0.62 mm per year.
Conclusions: The measurements evaluated in this study are essential for the diagnosis, follow-up, and treatment approach in hip pathologies during growth. More extensive research is needed to define normal ranges that will serve as a baseline for anatomy restoration in hip joint preservation surgery.
Materials and Methods: Retrospective study evaluating CT images of the hips of healthy patients under 18 years. The following measurements were taken by a trained orthopedist: femoral offset, femoral neck length,femoral head diameter, and neck-shaft angle.
Results: Femoral offset increases by 1.96 mm until age 12.5. From 12.5 to 16 years of age, it increases by 1.2 mm. A constant rise in the growth of the femoral neck length was found. The neck-shaft angle presented a progressive decrease until age 12. After that point, the curve flattened. An increase in femoral head diameter of 1.56 mm per year was observed until age 13 and then 0.62 mm per year.
Conclusions: The measurements evaluated in this study are essential for the diagnosis, follow-up, and treatment approach in hip pathologies during growth. More extensive research is needed to define normal ranges that will serve as a baseline for anatomy restoration in hip joint preservation surgery.
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How to Cite
Huertas Tafur, R., Solano Noguera, A. J., García Rueda, M. F., Rashid Forero, H. R., & Caicedo Gutiérrez, M. L. (2024). Description of Proximal Femoral Growth in Pediatric Patients Without Hip Disorders Using Tomography. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(4), 365-373. https://doi.org/10.15417/issn.1852-7434.2024.89.4.1816
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Clinical Research
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References
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Rubas HE (eds). The adult hip. Philadelphia: LWW; 1988, p. 81-90.
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McGraw-Hill; 2011.
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6. Lecerf G, Fessy MH, Philippot P, Massin P, Giraud F, Flecher X, et al. Femoral offset: Anatomical concept,
definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 2009;95(3):210-9. https://doi.org/10.1016/j.otsr.2009.03.010
7. Szuper K, Tibor Schlégl Á, Leidecker E, Vermes C, Somoskeöy S, Than P. Three-dimensional quantitative analysis of the proximal femur and the pelvis in children and adolescents using an upright biplanar slot-scanning X-ray system. Pediatr Radiol 2015;45(3):411-21. https://doi.org/10.1007/s00247-014-3146-2
8. López-Laiseca JD, Massuça LM. Valores de referencia para estatura, peso e índice de masa corporal en niños,
niñas y adolescentes de 2 a 18 años. Una revisión sistemática con énfasis en la población colombiana. Rev Fac Med [Internet] 2021;69(1):e300. https://doi.org/10.15446/revfacmed.v69n1.88774
9. Amador A, Gil C, Gutiérrez J, Duque C. Center of the femoral head in children: Anatomic-radiologic correlation. J
Pediatr Orthop 2003;23(6):703-7. PMID: 14581770
10. Wientroub S, Tardiman R, Green I, Salama R, Weissman SL. The development of the normal infantile hip as
expressed by radiological measurements. Int Orthop 1981;4(4):239-41. https://doi.org/10.1007/BF00266063
11. Kleinberg S, Lieberman HS. The acetabular index in infants in relation to congenital dislocation of the hip. Arch Surg 1936;32(6):1049-54. https://doi.org/10.1001/archsurg.1936.01180240137007
12. Than P, Sillinger T, Kránicz J, Bellyei A. Radiographic parameters of the hip joint from birth to adolescence. Pediatr Radiol 2004;34(3):237-44. https://doi.org/10.1007/s00247-003-1119-y
13. Novais EN, Pan Z, Autruong PT, Meyers ML, Chang FM. Normal percentile reference curves and correlation of
acetabular index and acetabular depth ratio in children. J Pediatr Orthop 2018;38(3):163-9.
https://doi.org/10.1097/BPO.0000000000000791
14. Byrne DP, Mulhall KJ, Baker JF. Anatomy & biomechanics of the hip. The Open Sports Medicine Journal 2010;4:51-7. https://doi.org/10.2174/1874387001004010051
15. Monazzam S, Bomar JD, Cidambi K, Kruk P, Hosalkar H. Lateral center-edge angle on conventional radiography and computed tomography. Clin Orthop Relat Res 2012;471(7):2233-7. https://doi.org/10.1007/s11999-012-2651-6
center of rotation of femoral head in Indian population. J Clin Orthop Trauma 2020;11(Suppl 4):S522-S525.
https://doi.org/10.1016/j.jcot.2020.04.017
2. Pauwels F. Biomechanics of the normal and diseased hip. Berlin: Springer; 1976, p. 8-21.
3. Johnston JD, Noble PC, Hurwitz DE, Andriacchi TP. Biomechanics of the hip. En: Callaghan J, Rosenberg AG,
Rubas HE (eds). The adult hip. Philadelphia: LWW; 1988, p. 81-90.
4. Muñoz Gutiérrez J. Atlas de mediciones radiográficas en ortopedia y traumatología. [Internet] 2a ed. México:
McGraw-Hill; 2011.
5. Birkenmaier C, Jorysz G, Jansson V, Heimkes B. Normal development of the hip: a geometrical análisis based on planimetric radiography. J Pediatr Orthop B 2010;19(1):1-8. https://doi.org/10.1097/BPB.0b013e32832f5aeb
6. Lecerf G, Fessy MH, Philippot P, Massin P, Giraud F, Flecher X, et al. Femoral offset: Anatomical concept,
definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 2009;95(3):210-9. https://doi.org/10.1016/j.otsr.2009.03.010
7. Szuper K, Tibor Schlégl Á, Leidecker E, Vermes C, Somoskeöy S, Than P. Three-dimensional quantitative analysis of the proximal femur and the pelvis in children and adolescents using an upright biplanar slot-scanning X-ray system. Pediatr Radiol 2015;45(3):411-21. https://doi.org/10.1007/s00247-014-3146-2
8. López-Laiseca JD, Massuça LM. Valores de referencia para estatura, peso e índice de masa corporal en niños,
niñas y adolescentes de 2 a 18 años. Una revisión sistemática con énfasis en la población colombiana. Rev Fac Med [Internet] 2021;69(1):e300. https://doi.org/10.15446/revfacmed.v69n1.88774
9. Amador A, Gil C, Gutiérrez J, Duque C. Center of the femoral head in children: Anatomic-radiologic correlation. J
Pediatr Orthop 2003;23(6):703-7. PMID: 14581770
10. Wientroub S, Tardiman R, Green I, Salama R, Weissman SL. The development of the normal infantile hip as
expressed by radiological measurements. Int Orthop 1981;4(4):239-41. https://doi.org/10.1007/BF00266063
11. Kleinberg S, Lieberman HS. The acetabular index in infants in relation to congenital dislocation of the hip. Arch Surg 1936;32(6):1049-54. https://doi.org/10.1001/archsurg.1936.01180240137007
12. Than P, Sillinger T, Kránicz J, Bellyei A. Radiographic parameters of the hip joint from birth to adolescence. Pediatr Radiol 2004;34(3):237-44. https://doi.org/10.1007/s00247-003-1119-y
13. Novais EN, Pan Z, Autruong PT, Meyers ML, Chang FM. Normal percentile reference curves and correlation of
acetabular index and acetabular depth ratio in children. J Pediatr Orthop 2018;38(3):163-9.
https://doi.org/10.1097/BPO.0000000000000791
14. Byrne DP, Mulhall KJ, Baker JF. Anatomy & biomechanics of the hip. The Open Sports Medicine Journal 2010;4:51-7. https://doi.org/10.2174/1874387001004010051
15. Monazzam S, Bomar JD, Cidambi K, Kruk P, Hosalkar H. Lateral center-edge angle on conventional radiography and computed tomography. Clin Orthop Relat Res 2012;471(7):2233-7. https://doi.org/10.1007/s11999-012-2651-6