Proksimal Femur Bilgisayarlı Tomografisi Kullanılarak Femoral Anteversiyon Ölçümü

Abstract

Ertaş. E.S., Femoral Anteversion Measurement Using Proximal Femoral Computed Tomography, Hacettepe University Graduate School of Health Sciences Anatomy Doctor of Philosophy Thesis, Ankara, 2021. In this study, it was investigated whether the femoral anteversion angle can be measured using anatomical landmarks determined in proximal femoral computed tomography. Computed tomography of 61 dry femoral bones obtained from cadavers was taken. The anteversion angles of the femur bones were determined using the standard technique in the literature to measure femur anteversion (the angle between the posterior condylar axis and the projective line connecting the centers of the caput femoris and collum femoris). In axial sections of computed tomography, retroversion angles of the trochanter major and trochanter minor were measured using the axis that projectively connects the centers of caput femoris and collum femoris. In addition, the intertrochanteric axis that projectively connects the most prominent parts of these anatomical structures in axial sections was determined. The transepicondylar axis connecting the most prominent points of the epicondylus femoris medialis and lateralis structures was determined and the angle values between the posterior condylar axis and the posterior condylar axis were measured. The average femoral anteversion degrees were found to be 9.4° (between -8° and 19°) in the measurements. There was no correlation between the femoral anteversion measurements made with reference to the posterior condylar axis and the transepicondylar axis. The mean trochanter major retroversion angle was 13.3° (between 7° and 21°), and the mean of the trochanter minor retroversion angle was 54.8° (between 40° and 78°). Although there is no relationship between the intertrochanteric axis and the posterior condylar axis, femurs with trochanter minor retroversion ˂50° have statistically significant relationship was found in terms of the angle between the posterior condylar axis and the intertrochanteric axis between -3° and +3° (P = 0.029). It was found that the trochanter major retroversion increased proportionally in femurs with femoral retroversion. This study demonstrates that femoral anteversion can be measured using only proximal femur computed tomography without using distal sections, and that trochanter major retroversion is associated with femoral retroversion.